flexible nails

Types

Age 0 - 5

- Salter Harris I

Age 5 - 11

- Salter Harris II

III / IV rare

Issues

Great remodelling potential

- 80% growth of humerus from proximal physis

Shoulder ROM compensatory

Age

- even older adolescents do well

Ossification

Primary

- 8 / 52 gestation radius & ulna

Secondary

- distal radius age 1

- distal ulna age 5

Non Operative Management

Unacceptable Position

< 10:  > 15^o malalignment

> 10:  > 10^o malalignment

Postreduction Positionin / Rule of Thirds 

Displaced Tibial Shaft Fractures

Acceptable reduction

- varus / valgus < 5^o

- anterior / posterior < 5^o

- rotation 5^o

- shortening 10 mm

Poor remodelling potential

- valgus 

- apex posterior angulation  / recurvatum

- rotational alignment does not remodel

- shortening / in 2-10 year old average overgrowth is only 5mm

AKA

Simple Bone Cyst

Definition

A simple bone cyst is a solitary cavity containing clear fluid

- originating in the metaphysis of growing children

- adjacent to the metaphyseal aspect of the growth plate.

Aetiology

Unknown pathological origin