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Published on: November 8, 2024
The management of traumatic fractures in children
1Department of Pediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria. Johannes.schalamon@meduni-graz.at
Insights
Pediatric fracture treatment varies by age, with a rising trend in surgical interventions and early mobilization. Treatment methods like K-wire osteosynthesis and elastic stable intramedullary nailing (ESIN) are age-dependent for pediatric fracture stabilization.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Traumatology
Background:
- Pediatric fractures necessitate age-specific treatment strategies.
- While conservative therapy is common, operative interventions for pediatric fractures increase with age.
- Recent trends show a move towards earlier surgical fixation and cast-free mobilization.
Purpose of the Study:
- To review current indications for operative stabilization of pediatric fractures.
- To discuss age-specific operative concepts for common pediatric fractures.
- To highlight evolving treatment trends in pediatric fracture management.
Main Methods:
- Review of current literature on pediatric fracture treatment.
- Analysis of age-dependent operative stabilization techniques.
- Focus on common pediatric fracture types and their management.
Main Results:
- Treatment strategies for pediatric fractures are age-dependent.
- K-wire osteosynthesis and elastic stable intramedullary nailing (ESIN) are prevalent in school-aged children.
- External fixation and plate osteosynthesis are common for adolescent fractures.
Conclusions:
- Surgical treatment of pediatric fractures is increasingly utilized, with methods tailored to age groups.
- Elastic stable intramedullary nailing (ESIN) and K-wire osteosynthesis are key for younger children.
- Adolescents benefit from external fixation and plate osteosynthesis, reflecting evolving pediatric fracture care.
Abstract:
Fractures in children require a specific treatment depending on age. While obstetric fractures usually heal well even in case of significant dislocations and conservative therapy, the proportion of operative interventions among all pediatric fractures is increasing with age. Though the vast majority of fractures in childhood are still treated non-operatively, a trend towards early operative interventions and cast-free mobilization has been noticeable in the recent years. The methods of operative stabilization differ between the respective age groups: While K-wire osteosynthesis and a minimal invasive approach using elastic stable intramedullary nailing (ESIN) are common in the group of school aged children, the use of external fixation and plate osteosynthesis has been accepted for the treatment of fractures in adolescents. Bioresorbable implants do not yet play a decisive role in the management of pediatric fractures. This review is focusing on the current indications and concepts for stabilization of frequent pediatric fractures.
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