How to manage and rehabilitate fractures in children

  Children’s bones are very immature and prone to trauma and fracture. Long-term braking and external fixation treatment can lead to muscle atrophy, re-fracture after disuse decalcification, joint adhesions, impaired joint function and stiffness. The ultimate goal of fracture treatment in children should be the full restoration of limb function, so the clinical treatment process of orthopedics also requires the early achievement of the ultimate goal through reasonable rehabilitation treatment. So, how can a child undergo effective emergency treatment, therapy and rehabilitation after a fracture?  First, parents must simply immobilize the injury site with a splint, brake and elevate the affected limb, and promptly take the child to a regular hospital pediatric orthopedic clinic for consultation and treatment; if there are wounds and bleeding, they should be pressure bandaged before visiting the hospital, and effectively intervene in proper rehabilitation at any stage of treatment.  Secondly, parents must also understand that rehabilitation of fractures in children consists of two phases: the period of cast fixation after fracture repositioning is the first phase of rehabilitation, and since the fracture site has a solid internal fixation or external fixation in a cast during this period, rehabilitation can be arranged as follows: cold and heat therapy, low-frequency electrical nerve stimulation therapy, the injury site should be subjected to early isometric muscle contraction, helping the child to elevate the affected limb and encouraging At the same time, joint activities and joint activities of adjacent joints should be carried out as early as possible without aggravating the disease or pain, starting with gentle exercises, slow and even movements, and then gradually increasing the amplitude and volume of movements after the muscle elasticity and strength have improved. The fracture healing situation and the effectiveness of rehabilitation treatment can be understood in a timely manner. The comprehensive rehabilitation after surgery and removal of external fixation is the second stage of treatment, which includes the following aspects: training of joint mobility (continuous passive training, heat therapy, joint loosening, application of orthopedic brace, etc.) and training to increase muscle strength (power-assisted exercise, active exercise, biofeedback training, etc.), which are indispensable for the child’s full recovery after the fracture. Otherwise, it may take a long time for the child to regain function or poor functional recovery.  It has been proved that after fracture repositioning and fixation, if correct functional exercises are carried out in time to give vertical physiological pressure to the fracture line, it can promote bone tissue proliferation, accelerate fracture healing, prevent muscle contracture and adhesion, and gradually restore the function of the already adherent and contracted joints, increase muscle strength, so that the child can get the maximum recovery of the injured part. Therefore, after surgery or removal of external fixation, early intervention of formal and child-appropriate comprehensive rehabilitation methods under the careful guidance of a full-time rehabilitation physician is an important means to shorten the duration of bone and joint disease, avoid or reduce residual disability, and fully recover function, but violent exercise and informal rehabilitation methods are strictly prohibited, and improper methods can cause serious consequences such as ossifying myositis and fatigue fractures.