Fractures That Raise Safeguarding Concern – Board-Style Questions

What this deck covers

fractures that raise safeguarding concern in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Too young for the story
2. A chip at the end of the bone
3. Behind, beside the spine
4. How that rib breaks
5. What he can actually do
6. Limping after the soft play
7. The one that means least
8. Bones that are hard to break
9. A mark before the movement
10. How old is the break
11. Not all at once
12. Looking again a fortnight on
13. What has to be ruled out
14. Born very small and very early
15. When to pass it on
16. Writing it down
17. What the parents are told
18. Who else is at home

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: The normal appearance of the other limb, A fragment separated across the end of the long bone, A fracture of the outer end of the collar bone, Traction on the arm transmitted along the collar bone, He has not reached the stage of rolling that it requires, A fine spiral crack of the shin in a walking toddler, Fractures of the ribs at several different ages, The elbow, the wrist and the bones of the arch of the foot, Bruising in a baby who is not yet moving independently, New bone appears within hours, so the timing is consistent, A generalised disorder of bone formation present from birth, No further imaging, as the first set was normal, Inherited bone fragility, rickets and copper deficiency, Bone weakened by a diet containing too much dairy produce.

Clinical pearls from this deck

• A fracture before the child can move needs explaining.
• A corner chip or a bucket handle: one planar fracture.
• Ribs broken near the spine are rarely accidental.
• Chest compression levers the rib against the spine.
• Test the explanation against what the child can do.
• A spiral shin crack in a walker is an everyday injury.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all MSK and orthopaedics case decks · pediatric reference values.