[Treatment of humeral shaft and subcapital fractures in children. Consensus report of the child trauma section of the DGU].
The orthopedic treatment is the first choice in shaft fractures of the humerus in children. Angulations of more than 10 degrees need reduction, in that case anesthesia should be used for surgical stabilization. The preferred method is the elastic-stable intramedullary nailing (ESIN). In adolescents, even unreamed interlocking medullary nails are used. The primary paresis of the radial nerve is not an indication for nerve exploration in principle, but may be useful in special fracture situations. In subcapital fractures, more distinct angulations can be left untouched because of the highly potent epiphyseal plate. In severe displaced fractures, reduction and stabilization by ESIN is recommended in patients over the age of 10 years. The method is even applicable to pathological fractures in juvenile bone cysts. In adolescents after the start of epiphyseal plate closure, angle-stable implants are an alternative.
Kinderchirurgische Klinik, Klinik St. Hedwig Krankenhaus Barmherzige Brüder, Regensburg. peter.schmittenbecher@barmherzige-regensburg.de
P P
PP
Schmittenbecher
J
J
Blum
St
S
David
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Knorr
I
I
Marzi
W
W
Schlickewei
G
G
Schönecker
D000293:Adolescent; D000367:Age Factors; D001845:Bone Cysts / Q000150:complications / Q000601:surgery; D002648:Child; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary; D005598:Fractures, Spontaneous / Q000601:surgery; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D011859:Radiography; D013997:Time Factors