What should I pay attention to when my child has a broken hand?

Then many people don’t understand, what is the ultimate goal of treating fractures? Especially nowadays, many children are running and jumping, and they often suffer hand fractures due to sudden falls or falling from a high place, being hit by other children, etc. There are several main reasons for the treatment of hand fractures. The first step is to recover through reduction, fixation and functional exercise, which are three methods.

1. Reset

(1) Early reduction of fractures can ensure smooth fracture repair. There are two methods of reduction: manual reduction and surgical reduction. If the reduction time is delayed too long, it will cause difficulty in fracture reduction.

Bone reduction is the first step in treating fractures. Therefore, in principle, anatomical alignment should be achieved for every fracture. However, for some fractures, reduction is difficult and although the anatomical position is not completely restored, the function of the injured limb is not affected after the fracture heals. This is called functional alignment. When treating fractures, emphasis should be placed on restoring the function of the injured limb rather than forcing anatomical reduction unilaterally and mechanically.

If the injured limb is severely swollen or even forms skin blisters, reduction will be more difficult. At this time, we should still strive to reduce the fracture. If we passively wait for the swelling to disappear, the reduction will often be delayed.

If the injured person is in a coma, shock, or has combined injuries to the internal organs, brain, etc., we must first concentrate our efforts on rescuing him. Only after his general condition stabilizes can the fracture be reduced.

(B) Standards for reduction Generally speaking, fracture reduction should strive to achieve anatomical alignment, or close to anatomical alignment. However, in clinical practice, due to differences in fracture site, fracture type, degree of swelling after fracture, equipment conditions during reduction, and technical level of the reducer, every effort should be made to achieve the best possible recovery of the affected limb based on the specific circumstances. The principle is that the fracture repair should not affect the patient's limb function.

1. Upper limbs: Humeral fractures, more shortening deformities and lateral displacement, and an angulation slightly exceeding 5° to 10° have little effect on the function of the affected limb. The requirements for ulna and radius fractures are stricter. The lateral displacement should not exceed 50%. When the angular deformity is below 5° to 10°, it has little effect on the forearm pronation and supination functions. The radius and ulna must be reduced at the same time.

2. Lower limbs: The shortening of lower limb fractures should not exceed 2cm. Excessive shortening will cause fractures, which will cause hip and waist pain over time. Rotational displacement should be corrected as much as possible. Internal or external rotation of the lower limbs will affect the gait of the lower limbs.

3. Children: The requirements for fracture reduction in children are wider. Generally, angulation and rotation deformity below 15°, as well as mild shortening or lateral displacement, can be compensated by the strong shaping ability during the development of children, and there will be no obvious functional impairment in the future.

4. Intra-articular fracture: For intra-articular fractures, when the bone sutures pass through the joint surface, higher reduction requirements are required and anatomical reduction should be achieved. For intra-articular fractures, if manual reduction cannot achieve satisfactory anatomical reduction, surgical reduction and internal fixation should be considered as appropriate.