Fundamentals of Nursing Q 328
The family of a 6-year-old with a fractured femur asks the nurse if the child’s height will be affected by the injury. Which statement is true concerning long bone fractures in children?
A. Growth problems will occur if the fracture involves the periosteum.
B. Epiphyseal fractures often interrupt a child’s normal growth pattern.
C. Children usually heal very quickly, so growth problems are rare.
D. Adequate blood supply to the bone prevents growth delay after fractures.
Correct Answer: B. Epiphyseal fractures often interrupt a child’s normal growth pattern.
Epiphyseal fractures often interrupt a child’s normal growth pattern. Growth plate fractures are classified based on which parts of the bone are damaged, in addition to the growth plate. Areas of the bone immediately above and below the growth plate may fracture. They are called the epiphysis (the tip of the bone) and metaphysis (the “neck” of the bone).
Option A: The most serious complication is early closure (complete or partial) of the growth plate. Complete closure means the entire growth plate of the affected bone has stopped expanding. This results in the affected bone not growing as long as the opposite side.
Option C: The severity of and need for treatment of growth plate closures depend on the location of the fracture and the age of the patient. Other complications of growth plate fractures include delayed healing of the bone, nonhealing, infection, and loss of blood flow to the area, causing death of part of the bone.
Option D: Growth plate fractures are generally treated with splints or casts. Sometimes, the bone may need to be put back in place to allow it to heal in the correct position. This may be done before or after the cast is placed and is called a closed reduction. The length of time the child needs to be in a cast or splint depends on the location and severity of the fracture. The child’s age also matters: younger patients heal faster than older patients.