Basic principles of fracture treatment in children

Abstract

This review aims to summarize the basic treatment principles of fractures according to their types and general management principles of special conditions including physeal fractures, multiple fractures, open fractures, and pathologic fractures in children. Definition of the fracture is needed for better understanding the injury mechanism, planning a proper treatment strategy, and estimating the prognosis. As the healing process is less complicated, remodeling capacity is higher and non-union is rare, the fractures in children are commonly treated by non-surgical methods. Surgical treatment is preferred in children with multiple injuries, in open fractures, in some pathologic fractures, in fractures with coexisting vascular injuries, in fractures which have a history of failed initial conservative treatment and in fractures in which the conservative treatment has no/little value such as femur neck fractures, some physeal fractures, displaced extension and flexion type humerus supracondylar fractures, displaced humerus lateral condyle fractures, femur, tibia and forearm shaft fractures in older children and adolescents and unstable pelvis and acetabulum fractures. Most of the fractures in children can successfully be treated by non-surgical methods.

Pediatric tibial shaft and distal metaphyseal fractures

“…The majority of PTFs includes shaft and distal metaphyseal parts (80-90%). [ 3 , 16 ] Accordingly, our study investigated the most commonly fractured part of the tibia. We had eleven different AO-PCCF type fractures and a heterogeneous distribution.…”

“…Different success rates of CRC treatment have been reported in the literature and even in adolescents. [ 3 - 5 , 12 , 14 , 16 ] We had 17 patients with 17 tibial fractures in the CRC group. Only one of those patients who was 16 years old needed operation due to delayed union.…”

Fiziyel yaralanmalara genel yaklaşım

“…Tedavide temel prensip kabul edilebilir bir redüksiyon elde edilirken fizin germinal tabakasına zarar vermemektir. [9] En büyük zorluklardan biri kabul edilebilir rezidüel deformite miktarının belirlenmesidir. Kabul edilebilir bir rezidüel redüksiyon miktarı; yaralanmanın yeri, hastanın yaşı ve yaralanmadan itibaren geçen süreye göre değişir.…”

Factors affecting re-displacement in pediatric forearm fractures and the role of cast indices

“…[ 1 ] The majority of the childhood diaphyseal forearm fractures are treated with manipulative reductions and loss of reduction is one of the most commonly reported complications. [ 2 , 3 ] The factors that cause loss of reduction can be categorized under three headings, related to the fracture, the surgeon or the patient. Fracture-based factors can be summarized as previous displacement, fracture localization, and the obliquity of the fracture, while surgeon-related factors are inadequate fracture reduction and poor casting technique, and patient- related factors are muscle atrophy and the regression of the soft tissue edema in the cast.…”