医学
物理
还原(数学)
矢状面
流离失所(心理学)
冠状面
口腔正畸科
半径
干预(咨询)
断裂(地质)
外科
物理医学与康复
射线照相术
放射科
计算机科学
计算机安全
工程类
心理学
几何学
数学
岩土工程
精神科
心理治疗师
作者
D S Liu,Martha M. Murray,Donald S. Bae,Collin May
标识
DOI:10.5435/jaaos-d-23-01233
摘要
Distal radius fractures are the most common skeletal injuries requiring intervention in children. These injuries are classified by fracture pattern, location, displacement, and angulation. While each unique fracture pattern warrants slightly modified treatment plans and follow-up, the goals of treatment remain constant. Successful outcomes depend on restoration of motion and function, and attaining acceptable sagittal and coronal alignment is a necessary first step. For displaced fractures, closed reduction is often necessary to restore alignment; well-molded cast application is important to maintain fracture alignment. Fractures with bayonet apposition, if well aligned, may not need formal reduction in some patients. Special attention should be paid to the physis—not only for physeal-involving fractures but also for all distal radius fractures—given that the proximity to the physis and amount of remaining skeletal growth help guide treatment decisions. Casting technique is essential in optimizing the best chance in maintaining fracture reduction. Surgical intervention may be indicated for a subset of fractures when acceptable alignment is not achieved or is lost at subsequent follow-up. Even among experts in the field, there is little consensus as to the optimal treatment of displaced metaphyseal fractures, illustrating the need for prospective, randomized studies to establish best practices.
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