Perry: Maternal Child Nursing Care, 4th Edition

Chapter 54: Musculoskeletal or Articular Dysfunction Key Points Print Immobility has a profound effect on all aspects of growth and development. The major physical consequences of immobilization are loss of muscle strength, endurance, and muscle mass; bone demineralization; loss of joint mobility; and contractures. Features of children s fractures not observed in the adult include presence of growth plate, thic!er and stronger periosteum, bone porosity, more rapid healing, and less joint stiffness. The goals of fracture management are to regain alignment and length of bony fragments, retain alignment and length, and restore function to injured parts. The method of fracture reduction is determined by the child s age, degree of displacement, amount of overriding, amount of edema, condition of the s!in and soft tissues, sensation, and circulation distal to the fracture. The primary purposes of traction are to fatigue involved muscles and reduce muscle spasm, position bone ends in desired realignment, and immobilize the fracture site until realignment has been achieved to permit casting or splinting. The etiology of ""# appears to be related to intrauterine, genetic, and cultural factors. Treatment of clubfoot consists of manipulation and casting to correct the deformity, maintenance of the correction, and prevention of possible recurrence of the deformity. $cquired hip deformities are managed with non%weight&bearing devices '(egg&)alv*& +erthes disease, or surgical stabilization '-)F.,. /bservation for idiopathic scoliosis is an important part of an adolescent s routine physical assessment. Idiopathic scoliosis is managed by observation, bracing, and e0ercise or surgical correction. 1one infections are managed with vigorous antibiotic therapy, immobilization of the affected part, and 'sometimes, surgical drainage. /steosarcoma is a neoplasm of bone&forming tissues; .wing s sarcoma is a neoplasm that arises from bone marrow spaces. 2habdomyosarcoma may occur almost anywhere in the body, but the most common sites are the head and nec!. 3ursing care of the child with juvenile arthritis consists of promoting general health, relieving discomfort, preventing deformity, and preserving function. -(. is a chronic autoimmune disorder that affects the collagen tissues of the body.

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