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Pediatric Orthopedics

Advanced Pediatric Orthopedics at Medical City Frisco

At Medical City Frisco, orthopedic surgery is about quality and care. From routine injuries to spinal fusions for scoliosis, our highly trained team is about creating a more comfortable experience. In addition, our KidKuts program ensures a plastic surgeon is on call 24/7 to help prevent permanent scarring. At Medical City Frisco, we understand that children deserve the highest level of care with a compassionate and encouraging touch.

Fractures

A bone fracture is a medical condition in which a bone is cracked or broken. About 15% of all injuries in children are fracture injuries. Bone fractures in children are different from adult bone fractures because a child’s bones are still growing. Also, more consideration needs to be taken when a child fractures a bone since it will affect the child in his or her growth.

Different types of fractures:

The bones of a child are more likely to bend than to break completely because they are softer and the periosteum is stronger and thicker. The fractures that are most common in children are incomplete fractures; these fractures are the greenstick and torus or buckle fractures.

Greenstick fracture:

This fracture involves a bend on one side of the bone and a partial fracture on the other side. The name is by analogy with green (i.e., fresh) wood which similarly breaks on the outside when bent.

Torus or buckle fracture:

This fracture occurs at the metaphyseal locations and resemble the torus or base of a pillar in architectural terms. Acute angulation of the cortex is noted, as opposed to the usual curved surface.

Closed fracture:

A fracture that doesn’t penetrate the skin.

Open (compound) fracture:

A fracture resulting in the ends of a bone penetrating the skin (these pose an increased risk of infection).

Non-displaced fracture:

A fracture where the bone cracks completely and the pieces line up.

Displaced fracture:

A fracture where the bone cracks completely in two or more pieces, and the pieces move out of alignment (this type of fracture might require surgery to make sure the pieces are aligned before casting).

Dislocations

A dislocation occurs when extreme force is put on a ligament, allowing the ends of two connected bones to separate. Ligaments are flexible bands of fibrous tissue that connect various bones and cartilage.

Ligaments also bind the bones in a joint together. Severe trauma on joint ligaments can lead to dislocation of the joint. The hip and shoulder joints are called “ball and socket” joints. Extreme force on the ligaments in these joints can cause the head of the bone (ball) to partially or completely come out of the socket.

Symptoms of a dislocation:

The following are the most common symptoms of a dislocation. However, each child may experience symptoms differently. Symptoms may include:

  • Severe pain in the injured area.
  • Swelling in the injured area.
  • Difficulty using or moving the injured area in a normal manner.
  • Deformity of the dislocated area.

How is a dislocation diagnosed?

The physician makes the diagnosis with a physical examination. During the examination, the physician obtains a complete medical history of the child and asks how the injury occurred.

Diagnostic procedures may help to evaluate the problem. Diagnostic procedures may include:

  • X-ray – a diagnostic test which uses invisible electromagnetic energy beams to produce images of bones onto film.
  • Magnetic resonance imaging (MRI) – a diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body.

Treatment for dislocation

All dislocations require immediate medical attention. Fractures can also occur with dislocations.

Initial treatment of a dislocation includes rest, ice and elevation). Dislocations may reduce spontaneously, meaning the bone ends may go back into place by themselves. However, for those dislocations that do not go back into place, your child’s physician will need to place the joint back into its proper position so it will heal. Your child will receive sedation to help him/her remain comfortable before the procedure. Sedation will also help the muscles around the dislocated joint relax, so the joint can be put back into place more easily.

Your child’s physician may recommend any of the following to help reduce the dislocation or promote healing afterwards:

  • Splint/cast – immobilizes the dislocated area to promote alignment and healing; protects the injured area from motion or use.
  • Medication (for pain control).
  • Traction – the application of a force to stretch certain parts of the body in a specific direction. Traction consists of pulleys, strings, weights, and a metal frame attached over or on the bed. The purpose of traction is to stretch the muscles and tendons around the bone ends to help reduce the dislocation.
  • Surgery (especially for reoccurring dislocations or if a muscle, tendon, or ligament is badly torn).

Additional recommendations may include:

  • Activity restrictions (while the dislocation heals).
  • Crutches/wheelchair (to enable your child to move around during healing).
  • Physical therapy (to stretch and strengthen the injured muscles, ligaments, and tendons).