Jani L
Helv Chir Acta. 1978 Dec;45(4-5):623-5.
Surgical treatment for fractures in childhood should be rare. Indications for open reduction and internal fixation is given especially in fractures within the joint region, which includes namely epiphyseal fractures, dislocated joint fractures (patella, olecranon, femoral neck, radial head, flake fractures) and dislocated ligament injuries. The same is true in children's fractures with accompanied vascular- or nerve-injuries and in multiple fractures, multiple injuries and open fractures grade III. A very relative indication to osteosynthesis is given in severe axial deviations which can not be corrected conservatively. In given in severe axial deviations which can not be corrected conservatively. In the last group the indication depends on the age of the child, localization of the fracture and the mainly displaced plane, but also depends on whether the department in question is experienced in and can fully exploid the conservative possibilities of closed reduction and stabilization.
儿童骨折的手术治疗应很少采用。切开复位内固定的适应证尤其适用于关节区域内的骨折,其中包括骨骺骨折、关节脱位骨折(髌骨、鹰嘴、股骨颈、桡骨头、片状骨折)以及韧带脱位损伤。伴有血管或神经损伤的儿童骨折、多发骨折、多处损伤和Ⅲ级开放性骨折也适用。对于严重的轴向畸形,若无法通过保守方法矫正,则进行骨固定是一个非常相对的适应证。在最后一组病例中,适应证取决于儿童的年龄、骨折的部位、主要移位平面,还取决于相关科室是否有经验且能否充分利用闭合复位和固定的保守方法。