[Spinal fractures in children and adolescents]

A follow-up study of more than hundred spinal fractures in children and adolescents pointed out that treatment and prognosis depends on the injury involving the growth-plate. In compression fractures without injury of the growth-plate spontaneous correction can be expected during further growth, especially if the wedge-shaped compression was in the sagittal plane alone. Spinal fractures with damage of the growth plate always result from a severe accident. These compound fractures, luxations and luxation-fractures require an exact repositioning and stable fixation to avoid growth disturbances such as progressive scoliosis and kyphosis originating from the unreduced fracture. Reposition and fixation can be managed by modern surgical methods more carefully, more exactly and with greater stability than with conservative methods. Furthermore surgical procedure allows removal of mechanical obstructions within the spinal channel. The origin, clinical appearance and treatment of apophyseal tearing out from the vertebral body are discussed.