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Accidents and Injuries in School. School Environment. Injuries - 3 % - 9 % annually Fractures - 5% - 10% of all school related injuries Rockwood and Wilkins Fractures in Children, 2001. Incidence of Injuries. Age distribution 13 – 17 year old (30%)
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School Environment • Injuries - 3 % - 9 % annually • Fractures - 5% - 10% of all school related injuries Rockwood and Wilkins Fractures in Children, 2001
Incidence of Injuries Age distribution • 13 – 17 year old (30%) • 6 – 9 year old (27%) • 1 – 5 year old (23%) • M : F 3 : 1 De la Calzada, Caballes and Javier, 1998
Incidence of Injuries Cause • Fall 78% • Traffic accidents 11% De la Calzada, Caballes and Javier, 1998
Incidence of Injuries Place • Home 41% • Streets 22.7% • School 20.7% De la Calzada, Caballes and Javier, 1998
Incidence of Fractures in Children Rockwood and Wilkins Fractures in Children, 2001
Overall Frequency of Fractures • % children with fractures (0 to 16 years of age) Boys 42% Girls 27% • % children with a fracture in a year: 1% - 2% Rockwood and Wilkins Fractures in Children, 2001
Common Childhood Fractures and Dislocations • Sports Injuries • Infections • Battered Child Syndrome
Fractures and Dislocations • What is a fracture? Injury caused by a break in the bone
Common Fractures • Wrist (distal radius) • Forearm (radio-ulna) • Elbow (supracondylar) • Collar bone (clavicle) • Thigh (femur)
Wrist Fractures • Common site of forearm fracture • Adolescence • Fall on an extended wrist
Wrist Fractures • Signs and Symptoms - swelling over wrist - tenderness - painful motion of wrist - gross deformity of wrist
Wrist Fractures • What to do? - Splint - Elevate hand - Seek medical consult
Forearm Fractures • Caused by landing on an outstretched upper extremity
Forearm Fractures • Signs and Symptoms - swelling of forearm - tenderness - deformity of forearm
Forearm Fractures • What to do? - Splint - Elevate hand - Seek medical consult
Elbow Fractures • 5 – 7 years old • Caused by falls
Signs and Symptoms - swelling of elbow - tenderness - limitation of elbow motion - deformity of elbow Elbow Fractures
Elbow Fractures • What to do? - Splint - Elevate arm - Seek medical consult
Clavicular Fractures • fall on the shoulder
Clavicular Fractures • Signs and Symptoms - swelling of shoulder - tenderness - limitation of shoulder motion - gross deformity of shoulder
Clavicular Fractures • What to do? - Sling - Seek medical consult
Femoral Shaft Fractures • Older children – high-energy injuries • Children younger than walking age ( <1 yo) – 80% caused by child abuse
Signs and Symptoms - swelling of thigh - tenderness - limitation of motion of lower extremity - deformity of thigh Femoral Shaft Fractures
Femoral Shaft Fractures • What to do? - Splint - Keep patient lying down - Seek medical consult
Fractures and Dislocations • What is a dislocation? Injury affecting the congruity of a joint
Common Dislocations • Elbow • Shoulder
Elbow Dislocations • Uncommon in children • 13 – 14 years old • Sports injuries • Fall on an outstretched arm
Elbow Dislocations • Signs and Symptoms - swelling of elbow - tenderness - limitation of elbow motion - deformity of elbow
Elbow Dislocations • What to do? - Splint - Elevate upper extremity - Seek medical consult
Shoulder Dislocations • Adolescence • Contact sports, falls, fights, and motor vehicle accidents
Shoulder Dislocations • Signs and Symptoms - swelling of shoulder - tenderness - limitation of shoulder motion - gross deformity of shoulder
Shoulder Dislocations • What to do? - Sling - Seek medical consult
Sports Injuries • Repetitive stress • Adolescence Data from Sports Clinic, UP-PGH, 2006
Sports Injuries • Most common type of sports associated with injuries - basketball - volleyball - badminton Data from Sports Clinic, UP-PGH, 2006
Acute Ankle sprains Forearm fractures (greenstick) Finger joint dislocations Chronic Back pains Knee pains Elbow pains Common Sports Related Injuries in Children Data from Sports Clinic, UP-PGH, 2006
Infections • Septic Arthritis • Osteomyelitis
Septic Arthritis • Inflammation of the joint • Pus-forming organisms • Newborn, infants and children (2 - 3 years old) Tachdjian Pediatric Orthopedics, 1990
Septic Arthritis • Involvement 1. Hip joint 2. Knee joint 3. Elbow joint Tachdjian Pediatric Orthopedics, 1990
Septic Arthritis • Bacteria enter the joint via: 1. Blood stream 2. Direct extension 3. Direct injection Tachdjian Pediatric Orthopedics, 1990
Septic Arthritis • Signs and Symptoms • Acute • Pain • Limitation of motion • Apprehensive, irritable, loss of appetite, and feverish • Joint - warm and swollen Tachdjian Pediatric Orthopedics, 1990
Septic Arthritis • Treatment • Antibiotics • Drainage and debridement • Splint - pain and prevent deformity • Function and congruency of joint Tachdjian Pediatric Orthopedics, 1990
Osteomyelitis • Infection of bone • Infants and children • Metaphysis of long bones Tachdjian Pediatric Orthopedics, 1990
Osteomyelitis • Routes of infection • Bloodstream • Direct extension • Open fractures Tachdjian Pediatric Orthopedics, 1990
Osteomyelitis • Signs and Symptoms • Pain • High fever, chills, vomiting and dehydration • tenderness over bone Tachdjian Pediatric Orthopedics, 1990