Contemporary approaches to osteosynthesis of child fractures


Authors: P. Havránek;  T. Pešl
Authors‘ workplace: Univerzita Karlova v Praze ;  3. lékařská fakulta ;  Klinika dětské chirurgie a traumatologie ;  Fakultní Thomayerova nemocnice, Praha ;  Přednosta: prof. MUDr. Petr Havránek, CSc., FEBPS
Published in: Prakt. Lék. 2008; 88(12): 700-706
Category: Various Specialization

Overview

First of all it is necessary to state that children’s fractures are predominantly not treated operatively but by orthopaedic methods, i.e. by closed reduction and plaster cast fixation. In our department 86.4 % of paediatric fractures are treated non-operatively, only 13.6 % are operated on. The German speaking European countries are most active in indicating the surgical treatment of child fractures. The U.K. and North American countries are traditionally conservative. However, nowadays a rapid increase in the number of indications for surgical approaches to skeletal trauma in children can be seen. It is influenced by several factors: better diagnostics of skeletal trauma (digital X-ray, X-ray amplifiers, CT with digital reconstruction, MRI, etc.), the possibility of a minimally invasive surgical procedure with C-arm X-ray amplifier navigation. One further reason can be seen in the revolutionary development of osteosynthetic implants. Not only the quality of the materials, (titanium wires, nails, screws and plates, bioabsorbable implants) but also the possibility of a minimally invasive procedure (intramedullary nails, cannulated screws, locked plates) are responsible for the increased number of operations. Contemporary surgical treatment of child fractures in strictly limited indications can ensure the treatment success without follow-up operations, a shortened hospital stay and recovery period of the injured child.

Key words:
child fractures, osteosynthesis, physis, elastic stable intramedullary mailing, minimal invasive osteosynthesis .


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General practitioner for children and adolescents General practitioner for adults
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