Children break bones more easily than adults - so pediatric fractures are very common. There are several unique features of the pediatric musculoskeletal system that need to be considered in management decisions of all of these injuries - growth plates, plasticity, callus formation, remodeling potential, and partial breaks are some of the key ones. Recognition and appropriate management of pediatric fractures by ED providers is critical. While some common minor wrist and ankle fractures can be treated with a less conservative approach encouraging an early return to activities, other fractures if not treated properly can result in long term functional problems for the child and/or be a sign of child maltreatment.



Clinical guidelines

Clinical Practice Guideline: Paediatric fracture guidelines


Victorian Paediatric Orthopaedic Network

Summary of paediatric fracture types, emergency department management, and information for fracture clinics.

Clinical Practice Guideline: Peripheral neurovascular checklist


SicKids Division of Orthopaedic Surgery

Peripheral Neurovascular Checklist.

Clinical Practice Guideline: Management of fractures in adolescents


Parikh, SN, Wells, L, Mehlman, CT & Scherl, SA

Summary of classifications, imaging, and treatments of fractures.

Clinical Practice Guideline: AboutKidsHealth: Tools for measuring pain


Stinson, J

Objectives: To assess the level of pain felt by children through the use of pain scales and other measurement tools such as behavioural and composite measures.

Clinical Practice Guideline: Splinting ABCs: upper and lower extremity splinting in the emergency department


Sarwark, JF, Maizels, M, Adler, MD & Nicholson, D

This guideline describes preparation and application of plaster and fiberglass short arm splints and short leg splints. Materials and set up for each type of splint are discussed in detail and the advantages and disadvantages of using fiberglass splints are outlined.