Why children’s fractures different?

1. In very young children à bone ends are largely cartilaginous & therefore do not show in x-ray è Fracture at these sites are difficult to diagnose
2. Children bone less brittle à more liable to plastic deformity compare to adult. Incomplete fractures – torus fracture (buckling of the cortex)& greenstick fractures are common in children compare to adult
3. Periosteum is thicker than in adult bones; this may explain why fracture displacement is more controlled
4. Cellular activity of periosteum is more active, which is why children’s fracture heal more rapidly than adult (the younger the quicker rate of union)
5. Non-union is very unusual
6. Bone growth involves modeling & remodeling à fracture deformity can be reshape to normal over time (except rotational deformity)
7. Damage to growth plate can have serious effect compare to adult