Ho Christine A
*Texas Scottish Rite Hospital for Children-Children's Health Dallas †Department of Orthopaedics, University of Texas Southwestern Medical School, Dallas, TX.
J Pediatr Orthop. 2016 Jun;36 Suppl 1:S15-8. doi: 10.1097/BPO.0000000000000762.
Despite the increasing popularity of operative treatment in adolescent tibia fractures, casting remains a viable first-line treatment. Because the selection bias in published reports does not allow direct comparison between casting and flexible nail treatment of closed pediatric tibia fractures, it is unclear whether flexible nailing offers any advantages over casting. This overview discusses parameters of acceptable alignment, indications, techniques for successful reduction and casting, subsequent inpatient and outpatient management including wedging of casted tibia fractures, expected outcomes, and comparison of casting with flexible nailing. As with any orthopaedic procedure, careful attention to patient selection, indications, and detail facilitates successful cast treatment in this older pediatric population.
尽管手术治疗在青少年胫骨骨折中越来越受欢迎，但石膏固定仍然是一种可行的一线治疗方法。由于已发表报告中的选择偏倚不允许对闭合性儿童胫骨骨折的石膏固定和弹性髓内钉治疗进行直接比较，因此尚不清楚弹性髓内钉治疗相对于石膏固定是否具有任何优势。本综述讨论了可接受对线的参数、适应症、成功复位和石膏固定的技术、后续住院和门诊管理（包括楔形石膏固定胫骨骨折）、预期结果以及石膏固定与弹性髓内钉治疗的比较。与任何骨科手术一样，在这个年龄较大的儿童群体中，仔细关注患者选择、适应症和细节有助于石膏固定治疗取得成功。
