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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(02): 191-198
DOI: 10.1055/s-0042-1748815
Artigo de Atualização
Ortopedia Pediátrica

Child Fractures: Are We Getting More Surgical?[*]

Article in several languages: português | English
Luiz Antônio Munhoz da Cunha 
1   Serviço de Ortopedia Pediátrica, Hospital Pequeno Príncipe, Curitiba, PR, Brasil
,
Mariana Demétrio de Sousa Pontes 
1   Serviço de Ortopedia Pediátrica, Hospital Pequeno Príncipe, Curitiba, PR, Brasil
› Author Affiliations Financial Support The authors declare that they have not received financial support from public, private, or non-profit sources for the conduction of the present study.
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Abstract

Historically, surgeries on the immature skeleton were reserved for open or articular fractures. In recent years, the improvement in the quality and safety of anesthesia, new imaging equipment, implants designed especially for pediatric fractures, associated with the possibility of shorter hospitalization time and rapid return to social life has demonstrated a new tendency to evaluate and treat fractures in children. The purpose of this update article is to answer the following questions: (1) Are we really turning more surgical in addressing fractures in children? (2) If this is true, is this surgical conduct based on scientific evidence? In fact, in recent decades, the medical literature demonstrates articles that support better evolution of fractures in children with surgical treatment. In the upper limbs, this is very evident in the systematization of the reduction and percutaneous fixation of supracondylar fractures of the humerus and fractures of the forearm bones. In the lower limbs, the same occurs with diaphyseal fractures of the femur and tibia. However, there are gaps in the literature. The available published studies show low scientific evidence. Thus, it can be inferred that, even though the surgical approach is more present, the treatment of pediatric fractures should always be individualized and conducted according to the knowledge and experience of the professional physician, taking into account the presence of technological resources available for the care of the small patient. All possibilities, non-surgical and/or surgical, should be included, always instituting actions based on science and in agreement with the family's wishes.

Keywords

cartilage, epiphyseal - fracture fixation, internal - fractures, growth plate - fractures, bone - orthopedics - pediatrics

* Work developed at Pequeno Príncipe Hospital, Curitiba, PR, Brazil.




Publication History

Received: 06 November 2021

Accepted: 28 March 2022

Article published online:
10 June 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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