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Open fractures in childhood

Trauma und Berufskrankheit, ISSN: 1436-6282, Vol: 18, Issue: 1, Page: 29-33
2016
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Article Description

Pediatric open fractures are rare with a proportion of less than 5 % of all fractures in children. In approximately one third of all cases the main location of these fractures is the forearm or the lower leg. In most cases the reasons for these injuries are often high impact force events, such as traffic accidents or a fall from a height. For this reason children should initially be treated according to international inclusion criteria and certain algorithms, such as advanced trauma life support in order not to overlook any life-threatening injuries. The classification of pediatric injuries is carried out as for adults according to Gustilo-Anderson; however, as a rule pediatric injuries with the same degree of severity have a better prognosis than these injuries in adults. At the same time, the treatment differs in many ways from adults, which is why it should be carried out in institutions with high expertise in pediatric injuries. Parents or custodians of the child should be involved in all decision-making processes from the very beginning. They should be aware of the characteristics of the pediatric organism with the high potential for spontaneous correction of the axis in the course of further growth up to the possibility of growth complications if the growth plate is damaged. In principle and as early as possible, calculated antibiotic treatment should be initiated. After rigorous cleansing and irrigation of the wound, a surgical intervention should follow in consideration of the characteristics of the pediatric organism in terms of the type of soft tissue management and the choice of implants for osteosynthesis.

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