Debunking rumors about children's orthopedic diseases 2丨Will children suffering from fractures and being in a cast for a long time lead to joint stiffness?

Rumors debunked: As long as children’s fractures are not complex joint fractures and there are no multiple and violent reductions, the final joint function will be good.

Children's bone quality is different from that of adults, and their epiphysis is special. Therefore, the treatment of fractures is also very different from that of adults. The principle of fracture treatment for children is "sparse internal fixation, strong external fixation". Smooth thin Kirschner wires are often used for fixation. After surgery, strong plaster external fixation is required. Rehabilitation training can only be carried out after the fracture heals. For adults, the principle is "strong internal fixation, early functional activities". Strong steel plates are often used for fixation, and rehabilitation training can be carried out early.

A common misconception is that parents worry that long-term immobilization will hinder joint movement, and prematurely remove the plaster external fixation or violent functional exercise, causing loosening of the internal fixation, leading to disastrous consequences such as nonunion of fractures, malunion, and myositis ossificans. On the contrary, some family members only pay attention to treatment methods and costs, and do not pay enough attention to rehabilitation exercises. They fail to guide their children's rehabilitation in time, which will also prolong the rehabilitation time and increase the difficulty of rehabilitation. Correct rehabilitation exercises for children after fractures should follow the principle of gradual progress, with the child's active activities as the main focus, and passive exercises by parents or rehabilitation therapists as the supplement. However, with the use of some external Chinese medicines for relaxing muscles and activating blood circulation, most people can eventually achieve satisfactory joint movement. Author: Liu Huanhuan, attending physician, Henan Luoyang Orthopedic Hospital (Henan Orthopedic Hospital)

Expert review:

Mu Xiaohong, Director of Orthopedics Department, Dongzhimen Hospital, Beijing University of Chinese Medicine, Vice Chairman of Bone and Joint Rehabilitation Committee, Chinese Rehabilitation Medicine Association

Chen Jiang, Chief Physician of Orthopedics Department, Dongzhimen Hospital, Beijing University of Chinese Medicine, Member of Bone and Joint Rehabilitation Committee of Chinese Rehabilitation Medicine Association