Pediatric Orthopedic Trauma, Principles In Management英文电子书.pdf

Pediatric orthopedic trauma: Principles in management Douglas S. Musgrave, MD; Stephen A. Mendelson, MD Optimal management of pediatric orthopedic trauma requires the fundamentals of the pediatric musculoskeletal system and pe- understanding the unique characteristics of the immature musculo- diatric orthopedic trauma management in general and as they apply skeletal system. The principles of pediatric orthopedic trauma man- to specific injuries. (Crit Care Med 2002; 30[Suppl.]:S431–S443) agement include anticipating future growth and bone remodeling KEY WORDS: musculoskeletal injuries; fractures; compartment potential, minimizing physeal injury, and aggressive treatment of syndrome open fractures and compartment syndromes. This article discusses usculoskeletal injuries are mation whereby bone is formed without a than ligaments or their insertions. Con- a leading cause of long- cartilaginous precursor. Long bones (fe- sequently, the physes are the most vul- Mterm morbidity and disabil- mur, humerus, radius, phalanges, etc.) nerable to failure. Physeal fractures are ity in pediatric trauma pa- undergo endochondral ossification most commonly classified using the Salt- tients (1). Physiologic and anatomic whereby bone replaces a preexisting car- er-Harris classification system (Fig. 1) differences such as persistent growth, tilage precursor. This endochondral ossi- (3). Type I physeal fractures consist of a bone remodeling potential, elastic bone, fication occurs at the physes (growth complete fracture through the hypertro- open physes, thick periosteum, and plates), resulti