Traumatic Pediatric Orthopedic Emergencies: An Approach to Evaluation and Management

Pediatric orthopedic injuries are commonly seen in emergency departments, and each injury has a unique management plan that differs from interventions in the adult population. This is largely attributed to the open physes in skeletally immature children, creating a “weak link” for fracture sites to occur. With advancements in the evaluation and management of traumatic orthopedic emergencies, it is important to review current management trends. This review focuses on changes seen in neurological compromise, vascular compromise, acute compartment syndrome, open fractures and fractures requiring urgent reduction. Overall, it is best to consult orthopedic surgery early in the course with any of these injuries, though timing of specific interventions has changed over the years. We have reviewed the current literature and best practices for each topic and provide an overview of the findings, current recommendations, and consensus of management as well as our recommendations if no standard management exists.