Unit of Pediatric Surgery and Orthopedics, Oulu University Hospital, and, PEDEGO Research Unit and MRC Oulu, Oulu Childhood Trauma and Sports Injury Study, University of Oulu, Oulu, Finland.
Department of Pediatric Surgery, Kuopio University Hospital, Kuopio, Finland.
Scand J Surg. 2021 Jun;110(2):276-280. doi: 10.1177/1457496920983104. Epub 2020 Dec 29.
Distal forearm is the most common fracture location in the growing skeleton. The aim of this article is to describe the current practice of these fractures.
Case series accompanied by experts' opinion.
Most of these injuries are benign incomplete distal metaphyseal torus fractures best treated with a dorsal below elbow splint for 2-3 weeks with no follow-up. Completely displaced metaphyseal fractures in prepubertal children can be either immobilized in bayonet position after axial alignment or fixed with K-wires after reduction. Complete fractures of distal metaphysis in adolescents should heal in near anatomic alignment because remodeling is uncertain. We advocate reduction of most greenstick and complete fractures at the distal metaphyseal diaphyseal junction and radiographic follow-up to monitor fracture alignment. Physeal fractures in adolescents and intra-articular fractures in children of all ages should be anatomically reduced. We perform most of our osteosyntheses with K-wires.
儿童生长骨骼中最常见的骨折部位是前臂远端。本文旨在描述此类骨折的治疗现状。
病例系列并结合专家意见。
这些损伤大多数为良性不完全性远端干骺端环骨骨折，最好采用背侧肘下夹板固定 2-3 周，无需随访。对于处于青春期前的儿童，完全移位的干骺端骨折可在轴向对线后用刺刀位固定，或复位后用克氏针固定。青少年的远端干骺完全骨折应在接近解剖对线的位置愈合，因为其重塑是不确定的。我们主张在大多数青枝骨折和完全骨折的干骺-骨干交界处进行复位，并进行影像学随访以监测骨折对线。青少年的骺板骨折和所有年龄段儿童的关节内骨折均应解剖复位。我们主要使用克氏针进行骨切开术。
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