Hanke Alexander, Scheerer-Harbauer Eva, Wulbrand Christian, Memmel Clemens
Department of Pediatric Surgery and Pediatric Orthopedics, Clinic St. Hedwig, Barmherzige Brueder Regensburg, KUNO Pediatric University Medical Center, 93049 Regensburg, Germany.
Department of Trauma Surgery, Orthopedics and Sports Medicine, Barmherzige Brueder Regensburg, 93049 Regensburg, Germany.
J Pers Med. 2024 Aug 9;14(8):842. doi: 10.3390/jpm14080842.
From a traumatological point of view, adolescents (12-18 years) represent a special group of patients. This is due to their biomechanical characteristics being between pediatric and adult fracture types. In Germany, they are treated by both pediatric and trauma surgeons. For this survey, seven cases of adolescent fractures were evaluated by both pediatric and trauma surgeons and their preferred treatment options were raised. The questionnaires were completed anonymously. Additionally, information on the specialty and years of experience were asked. In total, 126 valid questionnaires were obtained (from 78 pediatric and 48 trauma surgeons). The respondents' mean clinical experience was high (71.5% stated more than 10 years of surgical experience). For every single exemplary case, a significant difference in therapy decisions between the groups could be found. For the demonstrated seven cases, a tendency toward more operative and more invasive treatments was found with trauma surgeons compared to pediatric surgeons. On the other hand, there was a risk of underestimating the severity of fracture entities similar to adult fractures in pediatric surgeons. Overall, a continuous interdisciplinary exchange between both surgical specialties is necessary to ensure optimal treatment for adolescent fractures and to develop guidelines in the future.
从创伤学角度来看，青少年（12至18岁）是一类特殊的患者群体。这是因为他们的生物力学特征介于儿童和成人骨折类型之间。在德国，他们由儿科外科医生和创伤外科医生共同治疗。在本次调查中，儿科外科医生和创伤外科医生对7例青少年骨折病例进行了评估，并提出了他们倾向的治疗方案。调查问卷是匿名填写的。此外，还询问了专业领域和工作年限的信息。总共获得了126份有效问卷（来自78名儿科外科医生和48名创伤外科医生）。受访者的平均临床经验丰富（71.5%表示有超过10年的手术经验）。对于每一个示例病例，两组之间在治疗决策上都存在显著差异。对于所展示的7例病例，与儿科外科医生相比，创伤外科医生更倾向于采用手术和侵入性更强的治疗方法。另一方面，儿科外科医生存在低估类似成人骨折的骨折实体严重程度的风险。总体而言，两个外科专业之间持续的跨学科交流对于确保青少年骨折的最佳治疗以及未来制定指南是必要的。
