Stauffer U G
Prog Pediatr Surg. 1978;12:187-208.
Fractures in children heal more quickly than in adults. Stiffness of joints hardly ever occurs in children, even after prolonged immobilization. Pseudoarthrosis and Sudeck's atrophy are extremely rare. Axial, lateral and longitudinal malpositioning can be largely compensated by increased growth. Only rotation malpositions remain permanent in children. By and large, the treatment of fractures in childhood is therefore still conservative. Operative treatment is recommended for some types of fractures near joints, for fractures of the neck of the femur, and for some types of the fractures around the elbow. In all other types of fractures surgery should only be undertaken when the conservative methods fail. An exception may be in adolescents over 12 to 14 years of age and children with multiple trauma, especially cerebral trauma with consecutive spasticity. In these patients, conservative treatment with extension may be difficult and an osteosynthesis may facilitate general care.
儿童骨折比成人愈合得更快。即使长期固定后，儿童关节僵硬也很少发生。假关节和苏戴克萎缩极为罕见。轴向、侧向和纵向的位置异常在很大程度上可通过生长增加得到代偿。儿童仅旋转位置异常会持续存在。因此，总体而言，儿童骨折的治疗仍以保守为主。对于某些关节附近的骨折类型、股骨颈骨折以及某些肘部周围骨折，建议进行手术治疗。在所有其他类型的骨折中，只有当保守方法失败时才应进行手术。12至14岁以上的青少年以及有多处创伤的儿童，尤其是伴有连续性痉挛的脑外伤儿童，可能是个例外。在这些患者中，采用伸展的保守治疗可能困难，而骨固定术可能便于整体护理。
