[Experience with the management of childhood diaphyseal fractures]

Author reports on experiences gained during 10 years the diaphyseal fractures in childhood. Whereas certain types of fracture near to the joints have a generally accepted absolute operative indication, the surgery in diaphyseal fractures is rarely held to be indicated. Osteosynthesis was performed in 18 per cent of all cases. Surgery is thought to be indicated in open fractures, in fractures that cannot be reduced or that are unstable, in polytrauma and in bilateral cases. In closed fractures plate osteosynthesis, in severe open fractures the fixateur externe was found to be the best solution. In certain cases Kuntscher nailing of the femur, medullary splinting of the lower arm or diafixation of the lower leg are performed in older children.