Lower extremity injuries and fractures occur frequently in young children and adolescents. Nurses are often one of the first healthcare providers to assess a child with an injury or fracture. Although basic fracture care and principles can be applied, nurses caring for these young patients must have a good understanding of normal bone growth and development as well as common mechanisms of injury and fracture patterns seen in children. Similar to many of the injuries in the upper extremity, fractures in the lower extremity in children often can be treated nonoperatively with closed reduction and casting. However, this article will also review several lower extremity fractures that frequently require surgical intervention to obtain a precise anatomical reduction. Common mechanisms of injury, fracture patterns, and current management techniques will be discussed. Teaching strategies and guidelines that will enable nurses and nurse practitioners to confidently educate parents, families, and other providers caring for these young patients will be reviewed.
Erin S. Hart, MS, RN, CPNP, Pediatric Orthopaedic Nurse Practitioner, Massachusetts General Hospital for Children, Department of Orthopaedic Surgery, Yawkey Center for Outpatient Care, Boston, MA.
Brenda Luther, MS, RN, Doctoral Fellow, University of Utah, College of Nursing, Salt Lake City, UT.
Brian E. Grottkau, MD, Chief of Pediatric Orthopaedic Surgery, Massachusetts General Hospital for Children, Department of Orthopaedic Surgery, Yawkey Center for Outpatient Care, Boston, MA.