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Accidents and Injuries in School

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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Accidents and Injuries in School

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  1. Accidents and Injuries in School

  2. School Environment • Injuries - 3 % - 9 % annually • Fractures - 5% - 10% of all school related injuries Rockwood and Wilkins Fractures in Children, 2001

  3. 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

  4. Incidence of Injuries Cause • Fall 78% • Traffic accidents 11% De la Calzada, Caballes and Javier, 1998

  5. Incidence of Injuries Place • Home 41% • Streets 22.7% • School 20.7% De la Calzada, Caballes and Javier, 1998

  6. Incidence of Fractures in Children Rockwood and Wilkins Fractures in Children, 2001

  7. 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

  8. Common Childhood Fractures and Dislocations • Sports Injuries • Infections • Battered Child Syndrome

  9. Common Childhood Fractures and Dislocations

  10. Fractures and Dislocations • What is a fracture? Injury caused by a break in the bone

  11. Common Fractures • Wrist (distal radius) • Forearm (radio-ulna) • Elbow (supracondylar) • Collar bone (clavicle) • Thigh (femur)

  12. Wrist Fractures • Common site of forearm fracture • Adolescence • Fall on an extended wrist

  13. Wrist Fractures • Signs and Symptoms - swelling over wrist - tenderness - painful motion of wrist - gross deformity of wrist

  14. Wrist Fractures • What to do? - Splint - Elevate hand - Seek medical consult

  15. Forearm Fractures • Caused by landing on an outstretched upper extremity

  16. Forearm Fractures • Signs and Symptoms - swelling of forearm - tenderness - deformity of forearm

  17. Forearm Fractures • What to do? - Splint - Elevate hand - Seek medical consult

  18. Elbow Fractures • 5 – 7 years old • Caused by falls

  19. Signs and Symptoms - swelling of elbow - tenderness - limitation of elbow motion - deformity of elbow Elbow Fractures

  20. Elbow Fractures • What to do? - Splint - Elevate arm - Seek medical consult

  21. Clavicular Fractures • fall on the shoulder

  22. Clavicular Fractures • Signs and Symptoms - swelling of shoulder - tenderness - limitation of shoulder motion - gross deformity of shoulder

  23. Clavicular Fractures • What to do? - Sling - Seek medical consult

  24. Femoral Shaft Fractures • Older children – high-energy injuries • Children younger than walking age ( <1 yo) – 80% caused by child abuse

  25. Signs and Symptoms - swelling of thigh - tenderness - limitation of motion of lower extremity - deformity of thigh Femoral Shaft Fractures

  26. Femoral Shaft Fractures • What to do? - Splint - Keep patient lying down - Seek medical consult

  27. Fractures and Dislocations • What is a dislocation? Injury affecting the congruity of a joint

  28. Common Dislocations • Elbow • Shoulder

  29. Elbow Dislocations • Uncommon in children • 13 – 14 years old • Sports injuries • Fall on an outstretched arm

  30. Elbow Dislocations • Signs and Symptoms - swelling of elbow - tenderness - limitation of elbow motion - deformity of elbow

  31. Elbow Dislocations • What to do? - Splint - Elevate upper extremity - Seek medical consult

  32. Shoulder Dislocations • Adolescence • Contact sports, falls, fights, and motor vehicle accidents

  33. Shoulder Dislocations • Signs and Symptoms - swelling of shoulder - tenderness - limitation of shoulder motion - gross deformity of shoulder

  34. Shoulder Dislocations • What to do? - Sling - Seek medical consult

  35. Sports Injuries in Children

  36. Sports Injuries • Repetitive stress • Adolescence Data from Sports Clinic, UP-PGH, 2006

  37. Sports Injuries • Most common type of sports associated with injuries - basketball - volleyball - badminton Data from Sports Clinic, UP-PGH, 2006

  38. 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

  39. Infections

  40. Infections • Septic Arthritis • Osteomyelitis

  41. Septic Arthritis • Inflammation of the joint • Pus-forming organisms • Newborn, infants and children (2 - 3 years old) Tachdjian Pediatric Orthopedics, 1990

  42. Septic Arthritis • Involvement 1. Hip joint 2. Knee joint 3. Elbow joint Tachdjian Pediatric Orthopedics, 1990

  43. Septic Arthritis

  44. Septic Arthritis • Bacteria enter the joint via: 1. Blood stream 2. Direct extension 3. Direct injection Tachdjian Pediatric Orthopedics, 1990

  45. 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

  46. Septic Arthritis • Treatment • Antibiotics • Drainage and debridement • Splint - pain and prevent deformity • Function and congruency of joint Tachdjian Pediatric Orthopedics, 1990

  47. Osteomyelitis • Infection of bone • Infants and children • Metaphysis of long bones Tachdjian Pediatric Orthopedics, 1990

  48. Osteomyelitis • Routes of infection • Bloodstream • Direct extension • Open fractures Tachdjian Pediatric Orthopedics, 1990

  49. Osteomyelitis • Signs and Symptoms • Pain • High fever, chills, vomiting and dehydration • tenderness over bone Tachdjian Pediatric Orthopedics, 1990

  50. Osteomyelitis

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