What should I do if my child has a broken bone? Does he need surgery? When is the best time to have surgery?

Question preview:

◆When is the best time to have surgery for a child’s fracture?

◆Do children need surgery for all fractures? Is it okay not to have surgery?

◆The child had a broken bone in a car accident. Why didn’t the doctor perform surgery on him immediately?

◆The doctor put two long metal needles in my child’s bones. It looks scary. Will this affect the child’s bone marrow function?

◆The doctor performed an external fixator surgery on the child. After the surgery, the pinhole was red and yellow fluid was flowing out. Is this an infection?

1. When is the best time to undergo surgery for a child’s fracture?

Children are in the growth and development stage, and their fractures heal faster than those of adults. If a fracture is caused, surgery should be performed as early as possible, preferably no later than 10 days. If it is too late, new bones will grow, which will affect the results of the surgery and cause delayed healing.

2. Do children need surgery for all fractures? Is it okay not to have surgery?

Children are not miniatures of adults. As they grow and develop, most fractures can be reshaped. Even if there is partial shortening and angulation, they can be treated as they grow and develop. However, children need to grow taller, and there are places on the bones where they grow. If these places are fractured, surgery is recommended, otherwise it may affect growth in the future and may cause limb shortening, valgus and valgus deformity, etc. Open fractures, obviously displaced fractures, obviously deformed fractures, and intra-articular fractures often require surgery.

3. The child had a broken bone in a car accident. Why didn’t the doctor perform surgery on him immediately?

Traffic accident injuries are a serious form of trauma. In addition to fractures, they are often accompanied by injuries to the brain, chest, and abdomen. Because the clinical manifestations of fractures appear immediately after the injury, the deformities and swelling of the limbs are accompanied by severe pain. These prominent manifestations often mask the clinical manifestations of other important organs. The symptoms of these organ injuries often gradually worsen and may be fatal. After a child is involved in a traffic accident, the doctor often needs some time to closely observe the child's condition, mainly to observe those hidden and potentially fatal injuries. Only after other important injuries have been preliminarily ruled out can surgical treatment be performed. Rash treatment of fractures, the trauma itself combined with the surgical blow, may suddenly worsen the disease and even endanger the child's life.

4. The doctor put two long metal needles in my child’s bones. It looks scary. Will this affect the child’s bone marrow function?

The doctor put two long metal needles in the child's bones. The scientific name is elastic intramedullary nails, which are currently the ideal internal fixation method for treating long tubular bone fractures in children. Using intramedullary nails to fix long tubular bone fractures is like using an axis to pass through two bamboo tubes. Its advantages are that the fixation itself is relatively solid and reliable, and external fixation can be used less or not after surgery, which is conducive to early activity training of the injured limb; the skin incision is small, the range of periosteal stripping is limited, and the damage is small.

In the mesh between the bone marrow cavity of the human long bones and the loose bone of the flat bones, there is a spongy tissue. The bone marrow that can produce blood cells is slightly red and is called red bone marrow. When a person is born, the red bone marrow fills the whole body's bone marrow cavity. As the age increases, the number of fat cells increases, and a considerable part of the red bone marrow is replaced by yellow bone marrow. Finally, almost only the flat bone marrow cavity contains red bone marrow. Placing an elastic intramedullary nail in a child's long tubular bone will inevitably destroy the red bone marrow in the child's affected limb shaft. However, considering that the child's red bone marrow is mainly located in the flat bones and is in a state of gradual atrophy in the long tubular bone shaft, the surgical operation of simply fixing the long tubular bone with an intramedullary nail is not enough to affect the child's hematopoietic function. Therefore, the elastic intramedullary nail is still the preferred internal fixation method for treating fractures in children.

5. The doctor performed an external fixator surgery on my child. After the surgery, the pinhole was red and yellow fluid was flowing out. Is this an infection?

The needle hole will be red and yellow water will flow out after the operation. Sometimes it is a foreign body reaction caused by the steel nail. If there is obvious redness and swelling around the needle hole, it may be infected, but don't worry, change the dressing regularly and take oral anti-inflammatory drugs, and it will get better in a few days.