title: Changing trends in the management of children's fractures.
abstract: The management of children's fractures has evolved as a result of better health education, changes in lifestyle, improved implant technology and the changing expectations of society. This review focuses on the changes seen in paediatric fractures, including epidemiology, the increasing problems of obesity, the mechanisms of injury, non-accidental injuries and litigation. We also examine the changes in the management of fractures at three specific sites: the supracondylar humerus, femoral shaft and forearm. There has been an increasing trend towards surgical stabilisation of these fractures. The reasons for this are multifactorial, including societal expectations of a perfect result and reduced hospital stay. Reduced hospital stay is beneficial to the social, educational and psychological needs of the child and beneficial to society as a whole, due to reduced costs.
authors.affiliation: The Princess Alexandra Hospital NHS Trust, Harlow, Essex CM20 1QX, UK.
authors.forename: D
authors.initials: D
authors.lastname: Kosuge
authors.affiliation: The Royal London Hospital, London E1 1BB, UK.
authors.forename: M
authors.initials: M
authors.lastname: Barry
mesh_terms: D000293:Adolescent; D002648:Child; D002649:Child Abuse; D015897:Comorbidity; D005264:Femoral Fractures / Q000628:therapy; D005543:Forearm Injuries / Q000628:therapy; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D006801:Humans; D006810:Humeral Fractures / Q000628:therapy; D008318:Malpractice; D009765:Obesity / Q000453:epidemiology*; D009985:Orthopedics / Q000331:legislation & jurisprudence*; D011885:Radius Fractures / Q000628:therapy; D014458:Ulna Fractures / Q000628:therapy; D006113:United Kingdom / Q000453:epidemiology; D000092464:Elbow Injuries
keywords: Paediatric trauma; epidemiology; fractures; management