Sharma Akshat, Gupta Vikas, Shashikant Kumar
Department of Paediatric Orthopaedics, KUMC GURO Hospital, Seoul, Korea.
Central Institute of Orthopaedics, Safdarjung Hospital, New Delhi, India.
Indian J Orthop. 2018 Sep-Oct;52(5):470-480. doi: 10.4103/ortho.IJOrtho_319_17.
Open fractures in children differ from adults owing to their better healing potential. Management strategies for open fracture in children are changing with improvement in our understanding of soft-tissue reconstruction and fracture fixation. A literature review was performed for articles covering management of open fractures in children. The cornerstones of management include prevention of infection, debridement, and skeletal stabilization with soft-tissue coverage. The injury should be categorized according to the established trauma classification systems. Timely administration of appropriate antibiotics is important for preventing infections. Soft-tissue management includes copious irrigation and debridement of the wound. Fractures can be stabilized by a variety of nonoperative and operative means, taking into consideration the special needs of the growing skeleton and the role of a thick and active periosteum in the healing of fractures. The soft-tissue coverage required depends on the grade of injury.
儿童开放性骨折与成人不同，因其具有更好的愈合潜力。随着我们对软组织重建和骨折固定认识的提高，儿童开放性骨折的治疗策略也在不断变化。我们对涵盖儿童开放性骨折治疗的文章进行了文献综述。治疗的基石包括预防感染、清创以及通过软组织覆盖实现骨骼稳定。应根据既定的创伤分类系统对损伤进行分类。及时使用适当的抗生素对于预防感染很重要。软组织处理包括大量冲洗和清创伤口。考虑到生长中骨骼的特殊需求以及厚实且活跃的骨膜在骨折愈合中的作用，骨折可以通过多种非手术和手术方法实现稳定。所需的软组织覆盖取决于损伤的分级。
