Chapter 2520 【2520】Different Understanding
The scene of the car accident was tragic, the teacher protecting the child died, and her younger sister Xiaoyu was seriously injured and died. How could Shanshan be alone? 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 small saplings. What are the characteristics of small saplings? The branches are easy to break but the skin is connected. If the inside is broken, it is not obvious at first glance.
Children's bones are really like this. Because the bones are more tough and brittle than those of adults, and the periosteum is thicker, some children will have clinical phenomena like broken branches of young saplings. This feature is called subperiosteal fracture of greenstick fracture in pediatric orthopedics, which is different from adult fractures and is unique to pediatrics.
Like Shanshan, the doctors at the scene couldn't immediately tell whether she had hidden fractures. She didn't complain of pain herself, and her limbs didn't show obvious swelling. She needed to wait for the further development of the injury to show clinical symptoms. After being sent to the hospital from the emergency scene, the doctor's routine is to take radiographs of her limbs suspected of severe trauma to rule out bone abnormalities. After the film was taken, the X-ray examination report showed that the child was not a simple skin trauma, but had a supracondylar fracture of the humerus.
Where is the condyle of the humerus, simply put, in the patient's elbow area.
Elbow joint injuries in children include supracondylar humeral fractures, lateral humeral condyle fractures, radial neck fractures, and proximal ulna fractures. The most common genus ranked first is the supracondylar fracture of the humerus.
Supracondylar fractures of the humerus are characterized by frequent skeletal deformities and ischemic muscle contracture of the forearm, referred to as Volkmann's contracture.
In the clinical treatment of fractures, ordinary people usually know manual reduction, that is, orthopedic surgeons perform magical movements of the patient's limbs like martial arts masters, and then fix them with plaster. Sometimes the orthopedic surgeon will inform the patient and family members that surgical reduction is required if the manual reduction cannot be performed. At this time, some ordinary people will question, why do my family and his family have the same kind of fracture, some do not need surgery and some need to go to the operating room. Is it because I didn't send red envelopes and others gave doctors red envelopes.
Whether the doctor accepts the red envelope or not, I really dare not mess around with this kind of thing. Because of this kind of thing, once the medical records are sent to court in a lawsuit, the doctor can't afford to go around. The reason why there are huge and significant differences in the treatment plan for the same disease is generally due to different types. It is equivalent to saying that the common people think it is the same disease, but it is not completely true in the eyes of doctors.
Going back to the supracondylar fracture of the humerus, it can be divided into extension type and flexion type according to whether the elbow joint is in extension or flexion when the patient is injured. The former accounts for 90% of children's cases. Among them, the straight type is divided into three types according to the degree of fracture displacement. Like a straight type, there is no displacement, and manual reset is ok, so there is no need to go to the operating room for treatment. Shanshan is type 3, which belongs to severe displacement, and it is difficult to guarantee no recurrence by simple manual reduction. It needs to be combined with minimally invasive surgery to fix the fracture, so she can only go to the operating room.
"The child said that her sister would not undergo surgery before seeing her." Liu Huaiyu said, "For this reason, we have communicated with her parents several times and said that the surgery cannot be delayed."
Children's orthopedic surgery must be done as soon as possible, because children are in the growth and development stage, and fractures heal faster than adults.