Most Orthopaedic Surgeons are reluctant to internally fix fractures in children. There appears to be a false sense of security that most children’s fracture will heal and remodel with time. This, of course, is not always true. Left uncorrected they predispose to angular and growth deformities and even arthritic conditions in later life.
Certain displaced Paediatric fractures have a better functional result with alignment obtained by means of closed anatomic reduction without the need for an open procedure and maintenance with temporary internal fixation in the form of percutaneous wires or intramedullary nails. This has been made possible with the presently available imaging techniques. This is especially true when it comes to management of femoral fractures. In younger children and adolescents operative treatment appears to gives satisfactory results.
Economically also it appears to be a viable option, however the risks for surgery including growth disturbances need to be understood as we offer this modality of treatment to patients.
Dr. Bobby John,
Department of Orthopaedics, CMC