Closed reduction; cast or splint fixation
Main indication: Closed manipulation of simple fractures producing stable reduction (minimally displaced and angulated) possible
Simple oblique fractures are inherently unstable.
A well-molded cast and radiographic follow-up are recommended to ensure maintenance of satisfactory fracture position. If acceptable position cannot be obtained and maintained, operative stabilization should be considered.
Single bone fractures may be difficult to align by cast wedging.
- Residual angulation more than the age-related modeling capacity
- Residual displacement more than 50% of the shaft diameter in older children
- Multifragmentary fractures
- No requirement for implant removal
- High risk of displacement requiring additional general anesthetic and treatment
- Single bone fracture may be difficult to reduce and stabilize.
|Basic surgical experience, no specialized skills|
|Some specialized surgical experience|
|Highly experienced and skilled surgeon|
|Basic equipment only|
|Simple surgical and imaging resources|
|Full specialized surgical and imaging resources|