Pediatric Fracture Surgery

When to Consider Surgery for Pediatric Fractures

 

Pediatric fractures are common injuries that occur in children due to their active lifestyles and developing musculoskeletal systems. Generally, our doctors treat most fractures without surgery and just casting or splinting. However, certain types of fractures or specific circumstances may necessitate surgical intervention to ensure proper healing and function. In this context, this article explores when to consider surgery for pediatric fractures.  Additionally, it emphasizes why parents should seek specialized care at Medical City Kids Orthopedics and Spine Specialists.

Types of Pediatric Fractures

Before looking into when doctors recommend surgery, it’s essential to understand the various types of pediatric fractures:

• Greenstick Fractures: Incomplete fractures where the bone bends and cracks, common in younger children due to their softer bones.
• Buckle (Torus) Fractures: Compression fractures where one side of the bone buckles upon itself without breaking the other side.
• Complete Fractures: The bone appears broken into two or more pieces.
• Growth Plate Fractures: Occur at the growth plates, the areas of developing cartilage tissue near the ends of long bones in children.
• Displaced Fractures: The broken bone ends are out of alignment.
• Comminuted Fractures: The bone appears shattered into several pieces.
• Open (Compound) Fractures: The bone breaks through the skin, increasing the risk of infection.

Indications for Surgical Intervention

Doctors consider surgery for pediatric fractures in the following scenarios:

• Severe Displacement or Angulation: When the bones are significantly out of alignment, closed reduction (manipulating the bones without surgery) may solve the problem. However, surgical intervention, such as open reduction and internal fixation (ORIF), may ultimately be necessary to realign the bones properly.
• Open Fractures: Because these fractures require immediate surgical attention to clean the wound and prevent infection, surgery becomes necessary.  Furthermore, it is essential to stabilize the fracture and promote proper healing.
• Growth Plate Fractures: Since these fractures involve the growth plates, which are crucial for bone development, they will need pediatric fracture experts.  If not treated correctly, Growth Plate Fractures can lead to growth disturbances. In such cases, doctors may recommend surgery to ensure proper alignment and avoid long-term complications.
• Unstable Fractures: Fractures that are inherently unstable and prone to shifting even after casting or splinting may therefore require surgical stabilization.
• Joint Involvement: Fractures that extend into a joint (intra-articular fractures) often need surgery to restore joint surface anatomy and function. Additionally, the surgery will also reduce the risk of arthritis and other complications.
• Multiple Fractures: In cases where a child has sustained multiple fractures, doctors may recommend surgery. Here, surgery will address all injuries effectively and ensure optimal recovery.
• Failure of Non-Surgical Treatment: If a fracture does not heal properly or non-surgical treatment methods do not work, your doctor will suggest surgery.

Surgical Options for Pediatric Fractures

Several surgical techniques are used to treat pediatric fractures, depending on the type and location of the fracture:

• Closed Reduction and Percutaneous Pinning (CRPP): This minimally invasive technique involves realigning the bone fragments and stabilizing them with pins inserted through the skin.
• Open Reduction and Internal Fixation (ORIF): This procedure involves surgically exposing the fracture site to realign the bones and stabilize them with plates, screws, or rods.
• Intramedullary Nailing: the doctor inserts a metal rod into the marrow canal of the bone to provide internal support and stabilization.
• External Fixation: The surgeon will insert Metal pins or screws into the bone above and below the fracture site.  The surgeon will then connect them to an external frame, providing stability while the bone heals.

Recovery and Rehabilitation

The recovery period after surgery for pediatric fractures varies depending on the severity of the fracture.  Also, it depends on the type of surgery performed. Postoperative care may include:

• Immobilization: Doctors may immobilize the affected limb with a cast, splint, or brace to protect the surgical site and promote healing.
• Pain Management: Doctors may prescribe medications to manage pain and inflammation.
• Physical Therapy: Rehabilitation exercises and physical therapy are crucial to restore strength, flexibility, and function to the affected limb.
• Follow-Up Appointments: Regular follow-up appointments with the orthopedic surgeon will allow the doctor to monitor the healing progress.

Why Choose Medical City Kids Orthopedics?

When it comes to pediatric fractures, parents need specialized care from pediatric doctors for optimal outcomes. Medical City Kids Orthopedics and Spine Specialists offer several advantages for parents seeking the best possible care for their children:

• Experienced Pediatric Orthopedic Surgeons: The team at Medical City Kids Orthopedics includes highly trained and experienced pediatric orthopedic surgeons.  Each surgeon specializes in treating children’s fractures.
• Comprehensive Care: The institute provides a full spectrum of services, from diagnosis and non-surgical management to advanced surgical interventions and rehab.
• Child-Friendly Environment: The facility is designed as welcoming and comforting for children, reducing anxiety and promoting a positive healthcare experience.
• Advanced Technology: Medical City Kids Orthopedics utilizes the latest imaging and surgical technologies to ensure precise diagnosis and effective treatment.
• Individualized Treatment Plans: Each child receives a personalized treatment plan tailored to their specific needs, ensuring the best possible outcome.
• Multidisciplinary Approach: The team collaborates with other specialists, such as pediatricians, physical therapists, and pain management experts, to provide comprehensive care.
• Focus on Growth and Development: Special attention is given to preserving the child’s growth potential and preventing long-term complications associated with growth plate injuries.
• At the Southwest Scoliosis and Spine Institute, We focus on Scoliosis Diagnosis, Treatment, & Care for our Patients. Our fellowship-trained, board-certified expert orthopedic scoliosis surgeons, Richard Hostin, MD, Shyam Kishan, MD, and Kathryn Wiesman, MD specialize in all types of spine conditions, deformities, and scoliosis pain.
• We have offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, Texas,

Conclusion

While most pediatric fractures do not need surgery.  However, certain circumstances necessitate surgery to ensure proper healing and function. Recognizing the indications for surgery and seeking specialized care at Medical City Kids Orthopedics and Spine Specialists can make a significant difference in a child’s recovery and long-term health. With experienced surgeons, advanced technology, and a child-friendly approach, Medical City Kids Orthopedics and Spine Specialists is the ideal choice for parents seeking the best care for their children’s orthopedic needs.