Proximale Unterarm- und Radiushalsverletzungen beim Kind

Abstract

Correction potentialFractures of the lower arm differ with respect to spontaneous corrective possibilities and the consequences of residual malpositioning depending on the localization. Therefore, a differentiation into fractures of the proximal, middle and distal third of the lower arm is recommended. In contrast to adults, for treatment of lower arm fractures in children it is necessary to take the available correction potential into consideration.Therapy of radial head and neck fracturesFor therapy selection the age of the child, the deviation from the axis and the side-to-side displacement must be taken into consideration. The operative therapy of fractures of the radial head must consider the special perfusion situation. The aim of treatment is the anatomical repositioning of the radial head but a good reduction and stabilization can also be sufficient and are often preferred to open repositioning.Therapy of olecranon fracturesPrimary nondislocated fractures of the olecranon should be treated conservatively, whereby after 1 week an X-ray control is indicated in order to exclude a secondary dislocation. Dislocated intra-articular fractures of the olecranon should be treated surgically.Therapy of Monteggia fracturesIn comparison to adults, children with adequately treated Monteggia fractures show good functional results but the challenge of this type of injury in childhood lies in the difficult diagnostics and the rarity. In addition to the result of repositioning of the ulna, exact repositioning of the radial head in the proximal radioulnar and humeroradial joints is decisive for the functional result.