Boutis Kathy
Division of Emergency Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.
Pediatr Emerg Care. 2010 Feb;26(2):152-7; quiz 158-62. doi: 10.1097/PEC.0b013e3181ce310c.
The unlikely event of long-term complications in some pediatric fractures, such as midclavicular fractures, has allowed for management of these injuries with interventions that support the injured extremity rather than immobilize it while healing occurs. However, there is currently a growing body of evidence that advocates for this approach for some of the most frequently encountered pediatric fractures also at very low risk of future problems but, in contrast, have conventionally been managed with orthopedic consultation and rigid casting for several weeks. Therefore, this article will review the evidence that recommends that management of some of the most common upper and lower pediatric extremity fractures be treated with minimal interventions, such as removable splints and follow-up with a primary care provider.
某些小儿骨折(如锁骨中段骨折)出现长期并发症的可能性较小,这使得在处理这些损伤时,可以采用支持受伤肢体的干预措施,而不是在愈合过程中对其进行固定。然而,目前越来越多的证据表明,对于一些最常见的小儿骨折,即使未来出现问题的风险极低,也主张采用这种方法;相反,传统上这些骨折需要接受骨科会诊并进行数周的刚性石膏固定。因此,本文将回顾相关证据,这些证据建议对一些最常见的小儿上下肢骨折采用最小化干预措施进行治疗,如使用可拆卸夹板,并由初级保健提供者进行随访。