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Hello, I Would Like Clarification On Two Things Please. The

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Posted on Mon, 15 Feb 2021
Question: Hello,

I would like clarification on two things please. The first being, in a baby approximately 8 weeks of age, does a diaphyseal femur fracture that displaces, do so immediately with the trauma or can it be non displaced and then go on to displace later perhaps through manipulation of the legs? I have heard conflicting information regarding this, however, from a book from a paediatric radiologist it says, “the deformity almost always occurs immediately at the time of the fracture and is the result of the relative displaced positions of the broken ends of the bone at the site of the fracture”. Could you confirm if this is correct please?

Also, can an 8 week old baby move and kick a leg with a displaced or even non displaced, if that’s possible, femur fracture with a power of 5 out of 5 and a tone of normal?

Thank you kindly.
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Follow up: Dr. Vivek Chail (0 minute later)
Hello,

I would like clarification on two things please. The first being, in a baby approximately 8 weeks of age, does a diaphyseal femur fracture that displaces, do so immediately with the trauma or can it be non displaced and then go on to displace later perhaps through manipulation of the legs? I have heard conflicting information regarding this, however, from a book from a paediatric radiologist it says, “the deformity almost always occurs immediately at the time of the fracture and is the result of the relative displaced positions of the broken ends of the bone at the site of the fracture”. Could you confirm if this is correct please?

Also, can an 8 week old baby move and kick a leg with a displaced or even non displaced, if that’s possible, femur fracture with a power of 5 out of 5 and a tone of normal?

Thank you kindly.
doctor
Answered by Dr. Vivek Chail (8 hours later)
Brief Answer:
The deformity can depend on the cause of the fracture and weak bones

Detailed Answer:
Hi,
Thanks for writing in to us.

It is hypothetically difficult to think of major force being the possible causes of fracture in a baby a 8 weeks old. At such a young age, any fracture is usually the result of weak bones or unintentional trauma.

Coming to your question, I completely agree with the views of the pediatric radiologist saying that the deformity occurs at the time of injury however a deformity can take time to evolve in case of bones that are metabolically weak and if that is the cause of progression of injury, a slow chronic trauma or as a result of manipulation. So we are talking of different causes of fracture and case outcomes.

Regarding the kicking ability of the baby, this is a highly subjective question but in a non displaced fracture there might be normal power and tone.

Regards,
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Vivek Chail (0 minute later)
Brief Answer:
The deformity can depend on the cause of the fracture and weak bones

Detailed Answer:
Hi,
Thanks for writing in to us.

It is hypothetically difficult to think of major force being the possible causes of fracture in a baby a 8 weeks old. At such a young age, any fracture is usually the result of weak bones or unintentional trauma.

Coming to your question, I completely agree with the views of the pediatric radiologist saying that the deformity occurs at the time of injury however a deformity can take time to evolve in case of bones that are metabolically weak and if that is the cause of progression of injury, a slow chronic trauma or as a result of manipulation. So we are talking of different causes of fracture and case outcomes.

Regarding the kicking ability of the baby, this is a highly subjective question but in a non displaced fracture there might be normal power and tone.

Regards,
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Vivek Chail (7 hours later)
Hello,

Thank you for your reply.

Does your answer stay the same for all different types of fractures of the long bone such as transverse, oblique etc? Or is it more likely to fully displace with a spiral fracture etc?

Thanks again!
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Follow up: Dr. Vivek Chail (0 minute later)
Hello,

Thank you for your reply.

Does your answer stay the same for all different types of fractures of the long bone such as transverse, oblique etc? Or is it more likely to fully displace with a spiral fracture etc?

Thanks again!
doctor
Answered by Dr. Vivek Chail (18 minutes later)
Brief Answer:
Displacement is due to action of muscles pulling on bone fragments

Detailed Answer:
Hi,
Thanks for writing back to us.

The displacement of a fracture depends on the mechanical force in action at the time of fracture or after it. There are many tendons attached to the long bones and if any fracture causes decreased resistance then it causes pulling of the muscle to a side and more displacement. So the answer to your question is that displacement depends on the direction of the fracture and bone fragments and the tendons that are pulled due to it. Spiral fractures might give rise to more displaced fractures and is less in a transverse fracture but this can differ between fractures.

Regards,

Regards,
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Vivek Chail (0 minute later)
Brief Answer:
Displacement is due to action of muscles pulling on bone fragments

Detailed Answer:
Hi,
Thanks for writing back to us.

The displacement of a fracture depends on the mechanical force in action at the time of fracture or after it. There are many tendons attached to the long bones and if any fracture causes decreased resistance then it causes pulling of the muscle to a side and more displacement. So the answer to your question is that displacement depends on the direction of the fracture and bone fragments and the tendons that are pulled due to it. Spiral fractures might give rise to more displaced fractures and is less in a transverse fracture but this can differ between fractures.

Regards,

Regards,
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Vivek Chail (58 minutes later)
Brief Answer:
Thanks for sending the query

Detailed Answer:
Hi,
Thanks for sending the query.

Regards,
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Vivek Chail (0 minute later)
Brief Answer:
Thanks for sending the query

Detailed Answer:
Hi,
Thanks for sending the query.

Regards,
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Vivek Chail (0 minute later)
Hello,

Thank you for this. You’ve been really helpful.

Kind regards.
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Follow up: Dr. Vivek Chail (0 minute later)
Hello,

Thank you for this. You’ve been really helpful.

Kind regards.
Answered by
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6873 Questions

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Hello, I Would Like Clarification On Two Things Please. The

Hello, I would like clarification on two things please. The first being, in a baby approximately 8 weeks of age, does a diaphyseal femur fracture that displaces, do so immediately with the trauma or can it be non displaced and then go on to displace later perhaps through manipulation of the legs? I have heard conflicting information regarding this, however, from a book from a paediatric radiologist it says, “the deformity almost always occurs immediately at the time of the fracture and is the result of the relative displaced positions of the broken ends of the bone at the site of the fracture”. Could you confirm if this is correct please? Also, can an 8 week old baby move and kick a leg with a displaced or even non displaced, if that’s possible, femur fracture with a power of 5 out of 5 and a tone of normal? Thank you kindly.