Pediatric skeletal trauma: a review and historical perspective

Pediatric fractures are commonly classified into five types: plastic deformation, buckle fracture, greenstick fracture, complete fracture, and physeal injuries. The most important anatomic characteristic in the pediatric skeleton is the presence of growth plates and the thick periosteum. It is important to emphasize that just as adult intra-articular fractures require anatomic reduction, so do pediatric articular injuries. The periosteum in children contributes immensely to rapid fracture healing and helps in the reduction and in the maintenance of reduction. In this study, I review some basic principles for the treatment of fractures in children, the main complications of pediatric fractures, and the outcomes assessment in children. The main complications of fractures in children are malalignment, physeal arrest, and refracture cause by fast fracture healing. Nearly all fractures in children can be treated in a cast without worry about stiff joints or need for physical therapy to mobilize injured joints.