[Upper extremity immobilization techniques in children].

OBJECTIVE

Conservative treatment of stable fractures of the upper extremity in children.

INDICATIONS

Undisplaced and age-tolerable displaced fractures of the hand, forearm, and elbow.

CONTRAINDICATIONS

Open fractures.

TREATMENT OPTIONS

Forearm splint/forearm cast for stable injuries to the radius or ulna. Long arm splint/long arm cast for injuries to the radius and ulna and after reduction of the forearm, as well as for stable, undisplaced injuries to the elbow. Intrinsic plus splint for injuries to the four fingers (excluding the thumb) and metacarpus.

FURTHER TREATMENT

For stable injuries, immobilization for analgesia for 3-4 weeks. Clinical check after treatment. In the case of repositioned fractures or fractures displaced within the spontaneous correction limits, clinical-radiological control (if necessary, with cast wedging) after 1 week. Immobilization for 4 weeks (prepubertal children) or 5 weeks (pubertal children).

RESULTS

Conservative treatment of fractures of the upper extremity is still the gold standard today. In pediatric patients in particular, but also in adult patients, correct healing of the fracture with good analgesia can be achieved with manageable effort and a good cost-benefit ratio through correct cast immobilization. A measurable parameter for monitoring a good cast is the cast index.