title: [A new therapy concept for unstable shaft fractures of upper and lower extremities in the growing period--indication and technique].
abstract: Up to now it was recommended in the literature to treat diaphyseal shaft fractures in childhood conservatively. In this paper it is shown in the example of the forearm- and the femoral shaft fractures, that the effort of conservative treatment can be very high as it means primary and secondary reductions in anaesthesia, changes of treatments, duration of the hospitalisation, the number of radiological controls etc. In relation to the functional and clinical result at the time around consolidation this effort seems often enough not to be justified. Deliberating on this fact it is demanded to treat all those fractures primarily definitively. Therefore it is recommended to use half-conservative methods: the intramedullary dynamic pinning with only movement stability and external fixation with the possibility of full weight bearing. Therefore it is recommended to treat instable diaphyseal shaft fractures in the upper limb by dynamic nailing and those of the lower limb by external fixation.
authors.affiliation: Traumatologischen Abteilung, kinderchirurgischen, Klinik des Kinderspitals Basel.
authors.forename: L
authors.initials: L
authors.lastname: von Laer
mesh_terms: D001134:Arm Injuries / Q000628:therapy*; D001858:Bone Nails; D002648:Child; D016267:External Fixators; D050723:Fractures, Bone / Q000503:physiopathology / Q000628:therapy*; D006128:Growth; D006801:Humans; D007869:Leg Injuries / Q000628:therapy*
vernacular_title: Neues Therapiekonzept für die instabilen Schaftfrakturen der oberen und unteren Extremitäten in Wachstumsalter--Indikation und Technik.