Vopat Matthew L, Kane Patrick M, Christino Melissa A, Truntzer Jeremy, McClure Philip, Katarincic Julia, Vopat Bryan G
University of Kansas Medical Center , Kansas City, KS, USA.
Department of Orthopedics, Brown University , Providence, RI, USA.
Orthop Rev (Pavia). 2014 Jun 24;6(2):5325. doi: 10.4081/or.2014.5325. eCollection 2014 Apr 22.
Both bone forearm fractures are common orthopedic injuries. Optimal treatment is dictated not only by fracture characteristics but also patient age. In the pediatric population, acceptable alignment can tolerate greater fracture displacement due to the bone's ability to remodel with remaining growth. Generally, these fractures can be successfully managed with closed reduction and casting, however operative fixation may also be required. The optimal method of fixation has not been clearly established. Currently, the most common operative interventions are open reduction with plate fixation versus closed or open reduction with intramedullary fixation. Plating has advantages of being more familiar to many surgeons, being theoretically superior in the ability to restore radial bow, and providing the possibility of hardware retention. Recently, intramedullary nailing has been gaining popularity due to decreased soft tissue dissection; however, a second operation is needed for hardware removal generally 6 months after the index procedure. Current literature has not established the superiority of one surgical method over the other. The goal of this manuscript is to review the current literature on the treatment of pediatric forearm fractures and provide clinical recommendations for optimal treatment, focusing specifically on children ages 3-10 years old.
双侧尺桡骨骨折都是常见的骨科损伤。最佳治疗方案不仅取决于骨折的特征，还取决于患者的年龄。在儿童群体中，由于骨骼具有在剩余生长过程中重塑的能力，可接受的对线能够耐受更大程度的骨折移位。一般来说，这些骨折通过闭合复位和石膏固定即可成功处理，但有时也可能需要手术固定。目前尚未明确确定最佳的固定方法。目前，最常见的手术干预方式是切开复位钢板固定与闭合或切开复位髓内固定。钢板固定的优点在于许多外科医生对其更为熟悉，理论上在恢复桡骨弓形方面更具优势，并且有可能保留内固定物。最近，髓内钉固定因软组织剥离减少而越来越受欢迎；然而，通常在初次手术后6个月需要再次手术取出内固定物。目前的文献尚未确定一种手术方法优于另一种手术方法。本文的目的是回顾当前关于儿童前臂骨折治疗的文献，并提供最佳治疗的临床建议，特别关注3至10岁的儿童。
