The car accident scene was tragic. The teacher who was protecting the children died, and her younger sister Xiaoyu was seriously injured and died. How could Shanshan escape unscathed? It is for this reason that the doctor must be responsible for the child and cautiously ask him to stay in the hospital for observation.
We often describe children as saplings. What are the characteristics of saplings? Their branches are easy to break but the bark is still connected, and it is difficult to tell at first glance if something inside is broken.
This is really the case with children's bones. Because their bones are more tough, less brittle, and have a thicker periosteum than those of adults, some children will experience clinical phenomena like broken branches of saplings. This feature is called greenstick fracture and subperiosteal fracture in pediatric orthopedics. It is different from adult fractures and is unique to pediatrics.
Like Shanshan, the doctor on site could not immediately determine whether she had hidden fractures. She did not cry out in pain and her limbs had no obvious swelling. Clinical symptoms would only appear after the injury progressed further. After being sent to the hospital from the emergency scene, the doctor routinely had to take X-rays of her limbs that were suspected to have been severely injured to rule out bone abnormalities. After taking the film, the X-ray examination report showed that the child did not have a simple skin injury, but a supracondylar fracture of the humerus.
Where is the supracondylar part of the humerus? Simply put, it is in the patient's elbow area.
Children's elbow joint injuries and fractures include supracondylar fracture of the humerus, lateral condylar fracture of the humerus, radial neck fracture, and proximal ulna fracture. The most common genus is the supracondylar fracture of the humerus.
The characteristics of supracondylar fracture of the humerus are frequent bone deformity and ischemic muscle contracture of the forearm, also known as Volkmann contracture. As you can imagine, the result is very serious and can lead to disability.
When it comes to the treatment of clinical fractures, people usually know about manual reduction, that is, the orthopedic surgeon, like a martial arts master, magically bends the patient's limbs back together, seemingly twisting them around, and then fixes them with plaster. Sometimes the orthopedic surgeon will inform the patient and family that manual reduction is not possible and requires surgical reduction. At this time, some ordinary people will question why some people in my family and others in his family do not need surgery for the same fracture while others need to go to the operating room. Is it because I didn’t give a red envelope but others gave red envelopes to the doctor?
Whether the doctor accepts red envelopes or not, he would not dare to do anything wrong in such matters. Because in this kind of situation, if the medical records are sent to court, the doctor will be in big trouble. The reason why the treatment plans for the same disease are so different is generally due to different classifications. In other words, what ordinary people think is the same disease may not be the case in the eyes of doctors.
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Back to the supracondylar fracture of the humerus, it can be divided into extension type and flexion type according to whether the patient's elbow joint is in extension or flexion when the injury occurs. The former accounts for 90% of pediatric cases. Among them, the extension type is divided into three types according to the degree of fracture displacement. Like type 1 straight type, there is no displacement and it can be reduced by manipulation without going to the operating room. Shanshan's fracture is type three, which is severely displaced. It is difficult to prevent recurrence by manual reduction alone. She needs to undergo minimally invasive surgery to fix the fracture, and can only go to the operating room.
"The child said that she would not have the surgery until she saw her sister," Liu Huaiyu said. "We have discussed this with her parents several times and told them that the surgery cannot be delayed."
Orthopedic surgery for children must be performed as early as possible because children are in the growth and development stage and their fractures heal faster than those of adults.
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