Diepstraten A F, Bos C F, Pruijs J E
Academisch Ziekenhuis Rotterdam-Sophia Kinderziekenhuis, afd. Orthopedie.
Ned Tijdschr Geneeskd. 1998 May 16;142(20):1119-24.
Orthopaedic disorders in children differ in type from those in adults: most frequent are congenital anomalies and disorders of growth and development. The special nature and relative rarity of these conditions justify the separate development of this branch of the discipline. Fractures almost always heal normally after closed reduction and immobilization in a plaster cast; fractures close to epiphyseal discs and in joints require special attention. Slipping of the upper femoral epiphysis necessitates surgical fixation of the epiphysis. Benign bone tumours occur relatively often and mostly require no surgical intervention. The prognosis of solid malignant bone tumours has improved since the introduction of (neo)adjuvant chemotherapy and limb-sparing surgery. In case of difference in leg length, the length of both legs is predicted with the aid of roentgenological measurements. Inhibition of the growth of the longer leg gives rise to fewer complications than lengthening of the short leg. The essence of the treatment of growth disorders due to abnormal ossification of the cartilage is to monitor the natural repair process and to intervene if permanent malformation threatens.
最常见的是先天性异常以及生长和发育障碍。这些病症的特殊性质和相对罕见性证明了该学科这一分支的独立发展是合理的。骨折在闭合复位并用石膏固定后几乎总能正常愈合;靠近骨骺盘和关节处的骨折需要特别关注。股骨上端骨骺滑脱需要对骨骺进行手术固定。良性骨肿瘤相对常见,大多无需手术干预。自从引入(新)辅助化疗和保肢手术以来,实体恶性骨肿瘤的预后有所改善。在腿长有差异的情况下,借助X线测量来预测双腿的长度。抑制较长腿的生长比延长较短腿产生的并发症更少。由于软骨异常骨化导致的生长障碍的治疗要点是监测自然修复过程,并在有永久性畸形威胁时进行干预。