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Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling
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Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling

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The use of locked plating in skeletally immature patients

Kelly Vander Have1, Jose Herrera, Robert Kohen

  • 1Department of Orthopaedic Surgery, University of Michigan, TC2912, Box 5328, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5328, USA.

The Journal of the American Academy of Orthopaedic Surgeons
|July 31, 2008
PubMed

Insights

Pediatric fracture management has evolved, utilizing techniques like casting and internal fixation. The role of locked plating in treating immature bone fractures remains an underexplored area in pediatric orthopedics.

Area of Science:

  • Orthopedic surgery
  • Pediatric traumatology
  • Bone biology

Background:

  • Pediatric fractures differ significantly from adult fractures due to the unique properties of the immature skeleton.
  • Management strategies for pediatric fractures have evolved over decades, encompassing various surgical techniques.
  • Established methods include closed reduction and casting, internal fixation, and external fixation.

Purpose of the Study:

  • To review the evolution of pediatric fracture management techniques.
  • To highlight the principles of bridging plate osteosynthesis based on bone biology.
  • To identify the current gap in understanding the application of locked plating in skeletally immature patients.

Main Methods:

  • Literature review of pediatric fracture management strategies.
  • Discussion of bone biology principles relevant to fracture healing.
  • Comparative analysis of fixation techniques in adult versus pediatric populations.

Main Results:

  • The immature skeleton necessitates distinct approaches to fracture management compared to adults.
  • Bridging plate osteosynthesis has advanced, emphasizing vascularity preservation.
  • Locked plating is increasingly used in adult fractures, but its utility in pediatric cases is not yet defined.

Conclusions:

  • Pediatric fracture care requires specialized techniques considering skeletal immaturity.
  • Understanding bone biology is crucial for developing effective fixation methods.
  • Further research is needed to establish the role and safety of locked plating in pediatric fracture treatment.

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