[Shaft fractures in children and adolescents: age-appropriate treatment strategies]

Shaft fractures in children and adolescents differ from those of adulthood in terms of the fracture pattern and treatment. With respect to the procedure, humeral shaft fractures must be differentiated from forearm shaft fractures. Almost no axial deviation can be tolerated on the forearm shaft, even at a young age as this could lead to functional restrictions in the rotation of the forearm. For these reasons, closed reduction and elastic stable intramedullary nailing (ESIN) nowadays represents the gold standard for dislocated or unstable fractures. A special type is the greenstick fracture of the forearm shaft where there is also a risk of refracture due to the partial healing disorder. In the region of the humeral shaft, residual axial deviations play a role mainly with respect to the cosmetic results. Substantial functional limitations are not to be expected. Many of these fractures can be treated conservatively. In cases of instability or unacceptable dislocation, ESIN osteosynthesis is the first choice as a minimally invasive procedure for surgical treatment.