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儿童下肢骨折:第1部分:大腿及膝关节附近骨折

[Fractures of the lower extremities in childhood : Part 1: fractures of the thigh and in the proximity of the knee].

作者信息

Kremer L, Voth M, Marzi I

机构信息

Universitätsklinikum Frankfurt, Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.

出版信息

Chirurg. 2017 Oct;88(10):891-902. doi: 10.1007/s00104-017-0507-z.

Abstract

Fractures in children are a major challenge in everyday clinical practice. The decision about the correct treatment of fractures follows the consideration of individual factors. The age of the child and the resulting residual growth play an essential role. This article aims to facilitate a structured approach with respect to examination, diagnostics and treatment in clinical practice. This first part of this series deals with fractures of the thigh and in the proximity of the knee joint in children. The peculiarity of pediatric bone lies in its growth, which results not only in a much faster healing tendency than in adults but also possesses a greater correction potential. It is therefore very important for fracture healing to include the tolerance limits for existing axis misalignment as well as the expected spontaneous correction potential and the resulting remodeling in the therapy decision. The various operative measures must be used in a targeted manner. Incongruencies of joints as well as significant length differences should be avoided.

摘要

儿童骨折是日常临床实践中的一项重大挑战。关于骨折正确治疗的决策需考虑个体因素。儿童的年龄及其剩余生长情况起着至关重要的作用。本文旨在促进临床实践中检查、诊断和治疗的结构化方法。本系列的第一部分讨论儿童大腿及膝关节附近的骨折。儿童骨骼的特殊性在于其生长,这不仅导致愈合趋势比成人快得多,而且具有更大的矫正潜力。因此,在治疗决策中,将现有轴线错位的耐受限度、预期的自发矫正潜力以及由此产生的重塑纳入骨折愈合的考量非常重要。必须有针对性地使用各种手术措施。应避免关节不匹配以及明显的长度差异。

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