Abzug Joshua M, Mehlman Charles T
*Orthopedic Surgery, University of Maryland Medical Center, University of Maryland School of Medicine, Baltimore, MD; and †Division of Pediatric Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.
J Orthop Trauma. 2017 Nov;31 Suppl 6:S1-S5. doi: 10.1097/BOT.0000000000001013.
Pediatric phalangeal fractures are extremely common, especially among toddlers and older children/adolescents involved in sporting activities. The physical examination must include an assessment for deviation and malrotation. In addition, concomitant injuries must be assessed for such as tendon and/or neurovascular injuries. Plain radiographs are typically sufficient to make the diagnosis and determine the treatment. The majority of pediatric and adolescent phalangeal fractures can be treated with immobilization. Substantial deviation and malrotation must be addressed with closed reduction techniques with or without percutaneous pinning. Open reduction is reserved for cases with concomitant injuries, open fractures, older adolescents, and patients in whom an adequate closed reduction cannot be obtained. When diagnosed and treated appropriately, pediatric and adolescent phalangeal fractures typically result in excellent outcomes.
小儿指骨骨折极为常见，尤其是在参与体育活动的幼儿以及大龄儿童/青少年中。体格检查必须包括对畸形和旋转不良的评估。此外，还必须评估是否存在诸如肌腱和/或神经血管损伤等合并伤。普通X线片通常足以做出诊断并确定治疗方案。大多数小儿和青少年指骨骨折可通过固定进行治疗。明显的畸形和旋转不良必须采用闭合复位技术处理，可加用或不加用经皮穿针固定。切开复位仅适用于合并伤、开放性骨折、大龄青少年以及无法获得充分闭合复位的患者。如果诊断和治疗得当，小儿和青少年指骨骨折通常会取得极佳的治疗效果。
