SCIWORA and should prompt evaluation with MRI, which can best identify cord damage in the absence of a fracture Disposition For any thoracolumbar spine injury with associated neurologic abnormalities, admission is recommended for serial examinations and further evaluation Compression fractures without concern for burst injury may be discharged home with outpatient orthopedic follow-up Arrangements for back brace fitting may be required Referral for follow-up of thoracolumbar fractures is important because of complications that can occur related to the remaining growth potential of the spine, including deformity, instability, and neurologic injury Suggested Readings and Key References General Principles of Pediatric Orthopedics Flynn JM, Skaggs DL, Waters PM, eds Rockwood and Wilkins’ Fractures in Children 8th ed Philadelphia, PA: Wolters Kluwer Health; 2014 Swischuk LE, Siddharth PJ Emergency Musculoskeletal Imaging in Children New York: Springer; 2014 General Principles of Acute Orthopedic Care Boutis K Common pediatric fractures treated with minimal intervention Pediatr Emerg Care 2010;26(2):152–157; quiz 158–162 Shore BJ, Glotzbecker MP, Zurakowski D, et al Acute compartment syndrome in children and teenagers with tibial shaft fractures: incidence and multivariable risk factors J Orthop Trauma 2013;27(11):616–621 Thompson RW, Krauss B, Kim YJ, et al Extremity fracture pain after emergency department reduction and casting: predictors of pain after discharge Ann Emerg Med 2012;60(3):269–277 Trionfo A, Cavanaugh PK, Herman MJ Pediatric open fractures Ortho Clin North Am 2016;47(3):565–578 Triyyagura G, Beucher M, Bechtel K Nonaccidental injury in pediatric patients: detection, evaluation, treatment Pediatric Emerg Med Pract 2017;14(7):1–32 Injuries of the Shoulder Region Aronson PL, Mistry RD Intra-articular lidocaine for reduction of shoulder dislocation Pediatr Emerg Care 2014;30(5):358–362 Hubbard EW, Riccio AI Pediatric orthopedic trauma: an evidence-based approach Orthop Clin North Am 2018;49(2):195–210