https://www2.aofoundation.org/wps/portal/! ut/p/c1/04_SB8K8xLL ! SS"#$8xB"!%#0os&hng'B()$d*)w+&,w *(08"-"d. .xB/0w+_01B822K8ha345*'50!n#2 6#7+S3g84_/_"c9#2%&0h$(*2.4 w!/dl2/d1 /L2d2,S3.55t&,S!:,nB&L":f,"B;554% 53w)"3w *B2+6l8S0<5 "0w-"0! /=show#ag>?

startpag> 4>@oralAShaftA4rxAinA0nfants:A0AtoA2A$rs BA*iscussion: AAAABAchildAaCus>:AchildAaCus>AoccursAinA<0B80DAofAchildr>nAEA2A$rsAw/Af>@oralAfrxF AAAABAli@CAl>ngthAin>7ualit$Aar>As>ldo@AaAproCl>@Asinc>AfrxAdo>sAnotAshort>nA>xc>ssi.>l$F AAAABAacc>ptaCl>Ar>duction: AAAAAAAAAAABAinAchildr>nA$oung>rAthanA2A$rsGAshort>ningAofAupAtoA1B1.<Ac@AHAangulationAofA&0A d>gAar>Aacc>ptaCl>F BA)adiographs:AAAA BA-r>at@>nt: AAAABA>arl$AspicaAcastAisAoft>nApossiCl>GAifAth>r>AisAanAacc>ptaCl>Ar>ductionF AAAABAw/AanAunacc>ptaCl>Ar>ductionGAconsid>rAaAp>riodAofAs6inAtractionAusingA@odifi>dA Br$antIsAtractionAJthighs AAAAAAAAAAAinA4<Ad>gAfl>xionAandA&0Ad>gAaCductionKF AAAAAAAAAAABACothAl>gsAn>>dAtoAC>Aplac>dAinAtractionAtoAstaCili">Ath>Ap>l.isF AAAAAAAAAAABAcontraindicat>dAaft>rAth>Aag>AofA2A$rsAorAw/Aw>ightA@or>AthanA2<AlCsF AAAAAAAAAAABAd>lig>ntAs6inAcar>AisAaAr>7uir>@>ntF AAAABAunionAoccursAinAaCoutA2Aw>>6sF AAAABAl>gAw>a6n>ssAand/orAli@pA@a$Ap>rsistAforAon>A$>arF AAAABAinAth>Ar>portAC$ASA orrisA>tAalAJ2#LA2002KGAth>AauthorsAund>rtoo6AaAstud$AtoAass>ssA th>irAincid>nc>AandAoutco@>F AAAAAAAAAAABA'Apati>ntsAfro@AaAtotalAofA<<G2!1Ali.>ACirthsAsuff>r>dA8Af>@oralAfractur>sA Jincid>nc>A0.1&Ap>rA1G000Ali.>ACirthsKF AAAAAAAAAAABAtwinApr>gnanci>sGACr>>chApr>s>ntationsGApr>@aturit$GAandAdisus>Aost>oporosisA w>r>Aassociat>dAwithAth>Aoccurr>nc>AofAaAfractur>F AAAAAAAAAAABA.ari>t$AofAtr>at@>ntA@odaliti>sAw>r>Aus>dGAincludingAgallowsAtractionGAspicaAcastGA andA#a.li6Aharn>ssF AAAAAAAAAAABAallApati>ntsAinAthisAstud$GAr>gardl>ssAofAtr>at@>ntGAhadAaAsatisfactor$AclinicalA outco@>GAwithAnoA>.id>nc>AofAli@C AAAAAAAAAAAAAAAAAAAl>ngthAdiscr>panc$AorAangularAd>for@it$AonAfollowBupF AAAAAAAAAAABAr>f:A%hangingA#att>rnsAofA#>diatricA#>l.icA4ractur>sA;ithABirthB(ssociat>dA 4>@oralA4ractur>s:A0ncid>nc>AandALutco@> AAAAAAAAAAAAAAAAAAASA orris.A2A#>diatrALrthopA2002A2anuar$/4>Cruar$F22J1K:2'B&0 *iscussion: AAAABAchildAaCus>:A&0DAofAf>@oralAfrxAinAchildr>nAEA4A$rsAar>A2ndAtoAchildAaCus>F BAL.>rBridingAofA4ractur>A4rag@>nts:

AAAABAinAchildr>nAC>tw>>nAth>Aag>sAofA2B10A$rsGAo.>rgrowthAa.>rag>sA0.!Ac@F AAAABAinA6idsAC>tw>>nA2AHA10A$rsGAsid>AtoAsid>AappositionAw/A0.<AtoA1Ac@Ao.>rridingAisAth>A id>alApositionF AAAABAinAchildr>nAC>lowAag>sAofA8BA!A$rsGAupAtoA2Ac@AofACa$on>tAappositionAcanAC>Aacc>pt>dA withAnoAlongBt>r@Aad.>rs>A>ff>ctsF AAAAAAAAAABAo.>rgrowthAusuall$Acorr>ctsA@ostAofAth>Adiscr>panc$F AAAAAAAAAABAso@>Awor6>rsAstillAincorporat>AaAf>@oralApinAinAth>AcastF AAAABAr>f>r>nc>s: AAAAAAAAAABA4>@oralAshaftAfractur>sAinAchildr>n:Ath>A>ff>ctAofAinitialAshort>ningAonAsuCs>7u>ntA li@CAo.>rgrowth. AAAAAAAAAABA4ractur>sAofAth>Af>@oralAshaftAinAchildr>n.A-h>Ao.>rgrowthAph>no@>non. BA(ngulationAatA4rxASit>: AAAABAsaggitalAplan>Atol>rat>sA20B&0Ad>gAangulationAJacc>ptAl>ssAinAold>rAchildKF AAAABAfrontalAplan>Atol>rat>sA10B1<Ad>gAangulationF AAAABAlat>AangulationAisA@anag>dAw/Aw>dgingAofAth>AcastF BA-r>at@>nt: AAAABAacc>ptaCl>Ar>duction: AAAAAAAAABAinAthisAag>AgroupGAcanAC>Atr>at>dAw/A>arl$AspicaAcastAunl>ssAth>AfrxAo.>rrid>sAMA2A c@F AAAAAAAAABAspicaAcastAisAl>ftAonAforAapproxi@at>l$A1B8Aw>>6sF AAAABAunacc>ptaCl>Ar>duction:AJ@or>AthanA2Ac@Ao.>rridingKF AAAAAAAAABAw/AsignificantAshort>ningAofAli@CAatAfrxAsit>GAconsid>rAaAp>riodAofA!0B!0Ad>gAs6inA tractionAJinA$oung>rAchildr>nKAor AAAAAAAAAAAAAAAAdistalAf>@oralApinAtractionAJinAold>rAchildr>nKAtoA@aintainAad>7uat>Ali@CAl>ngthA untilA>arl$AcallusAfor@sG AAAAAAAAAAAAAAAAth>nAappl$AspicaA1B2Aw>>6sAlat>rF AAAAAAAAABAduringAth>Ap>riodAofAtractionGAth>AhipAusuall$An>>dsAtoAC>Afl>x>dAuptoA!0Ad>gAandA 6n>>Afl>x>dA!0Ad>g AAAAAAAAAAAAAAAAinord>rAtoAoCtainAr>ductionAduringA>arl$Aphas>AofAfrxAh>alingF AAAAAAAAAAAAAAAABAaft>rAfrxAC>co@>sAstic6$GAl>ssAhipAandA6n>>Afl>xionA@a$AC>Aacc>ptaCl>F AAAAAAAAAAAAAAAABAn>>dAtoAoCtainAw>>6l$AradiographsAtoAfollowAfrxAalign@>ntAandAl>ngthF AAAAAAAAAAAAAAAABAonc>AfrxAsit>AisAl>ssAt>nd>rAandAonc>AradiographsAshowA>arl$AcallusGAtractionA @a$AC>Adiscontinu>dF AAAAAAAAABAs6inAtractionAt>chni7u>Ap>arls: AAAAAAAAAAAAAAAABAappl$A@ol>s6inAstripsAorAS6inB-racAstripsAdir>ctl$AtoAs6inF AAAAAAAAAAAAAAAABAus>AnoA@or>AthanA'AlCsAofAtractionAforc>F AAAAAAAAABAinAso@>Acas>sGAaAdistalAf>@oralAtractionApinA@a$AC>Aincorporat>dAintoAth>AspicaAcastA JandAisAl>ftAinAplac>AforA&Aw>>6sKF AAAAAAAAABAfl>xiCl>A0 Anails: 4>@oralAShaftA4rx:A%hildr>nAag>dAMA10A$rs BAS>>:

AAAAAABA4>@oralA-ractionA#ins: BA*iscussion: AAAABAfro@A10AtoA1<A$rsGAconsid>rA!0/!0As6>l>talAtractionF AAAABAinAthisAag>AgroupGAs6>l>talAtractionAisAusuall$An>>d>dAtoAachi>.>Asatisfactor$Aalign@>ntA and AAAAAAAAAAA@ini@i">Ath>Ao.>ridingAofAth>AfrxAfrag@>ntsAuntilAcallusAfor@sAatAaCoutA&Aw>>6sF AAAABAaft>rA&Aw>>6sAappl$ASpicaA%ast: AAAABApot>nialAforAshort>ningAisAgr>at>rAinAthisAag>AgroupGAHAfurth>rAth>Apot>ntialAforAgrowthA acc>l>rationAisA@uchAd>clin>dF AAAABAunionAr>7uir>sA1Aw>>6sF AAAABAaft>rAag>A1<Atr>atAli6>AanAadultF B )adiographs:

L.>r.i>w *>spit>Ath>Asi">AandAstr>ngthAofAth>Af>@urAJth>ACon>AinAth>AthighKGAfractur>sAinAchildhoodA ar>AnotAunco@@on.A(A@otorA.>hicl>Aaccid>ntGAaAfallAfro@AaApi>c>AofApla$groundA >7uip@>ntGAorA>.>nAaApi>c>AofAfurnitur>AatAho@>A@a$Ar>sultAinAaACro6>nAl>gAthatAcanArang>A inAs>.>rit$Afro@AaAsi@pl>Ahairlin>Acrac6AtoAaAco@pl>xAin/ur$AthatAalsoAin.ol.>sAda@ag>AtoA surroundingAsoftAtissu>s. -r>at@>nt (sAinAadultsGAtr>at@>ntAgoalsAforAchildr>nAinclud>Aachi>.ingAprop>rAr>align@>ntAofAth>A Con>GApro@otingArapidAh>alingGAandAr>turningAth>Apati>ntAtoAnor@alAacti.iti>s.ANow>.>rGA th>r>Aar>AalsoAuni7u>AfactorsAandAconsid>rationsAinAth>Atr>at@>ntAofACro6>nACon>sAinA childr>nGAsa$sA*a.idA .ASch>rGA *GA(ssociat>ALrthop>dicASurg>onAatANospitalAforA Sp>cialASurg>r$AJNSSK.AO(longAwithAsuchAconsid>rationsAasAth>AconfigurationAofAth>A fractur>FAth>AP>n>rg$QAofAth>Ain/ur$FAandAth>Aa@ountAofAsoftAtissu>Ain/ur$Apr>s>ntGAp>diatricA orthop>distsAar>AalsoAguid>dAC$Aag>AandAsi">AofAth>Apati>ntFAth>Aa@ountAofAgrowthA r>@ainingFAandAth>Apot>ntialAforAan$Ashort>ningAofAth>ACon>AwhichAso@>ti@>sAoccursAatA fractur>Asit>s.R +>wCornsAandA0nfants 4>@urAfractur>sAinAn>wCornsAar>AunusualGACutAcanAoccurGAforA>xa@pl>GAinACaCi>sACornAwithA aAs6>l>talAd$splasiaAsuchAasAost>og>n>sisAi@p>rf>ctaABAalsoA6nownAasACrittl>ACon>Adis>as>ABA orAso@>ti@>sAfollowingAaA.>r$AdifficultAd>li.>r$.A4ractur>sAinAth>s>A.>r$A$oungAchildr>nA andAinAinfantsAar>Ausuall$Atr>at>dAC$AplacingAth>AchildAinAaA#a.li6Aharn>ssGAaAclothACrac>A thatAh>lpsAholdAth>AthighAinAth>Aprop>rApositionAwhil>AitAh>als.AO(tAthisA$oungAag>GA childr>nQsACon>sAh>alA.>r$Arapidl$GAusuall$AC$A&B4Aw>>6sGSAsa$sA*r.ASch>r. 4igur>A1:AA0@ag>AofA#a.li6Aharn>ssAonAaAchildAwithAd>.>lop@>ntalAhipAd$splasia.

5nli6>Ath>Ah>alingAproc>ssAinAadultsGAaAc>rtainAa@ountAofA.ariationAinAalign@>ntAofAth>A Con>AasAitAh>alsAisAacc>ptaCl>AinAinfantsAandAold>rAchildr>nGAnot>sA*r.ASch>r.A(sAth>ACod$A la$sAdownAn>wACon>GAo.>rAti@>GAth>r>AisAanAauto@aticAOcorr>ctionSAorAstraight>ningAduringA growthGAcall>dAr>@od>ling. -oddl>rsAtoA(g>A< (@ongAchildr>nAinAthisAag>AgroupGAf>@urAfractur>sAusuall$Ar>sultAfro@AaAlowA>n>rg$Afall.A 0nA@ostAcas>sGAth>Aorthop>dicAsurg>onAr>alignsAth>Afractur>AusingAfluoroscop$AorAxBra$A i@agingAasAaAguid>AandAi@@oCili">sAth>Al>gAinAaAt$p>AofAcastAcall>dAaAspicaAcast.A-hisA proc>dur>Ata6>sAplac>AinAth>Aop>ratingAroo@AandAaAp>diatricAan>sth>siologistAisApr>s>ntAtoA ad@inist>rAaAs>dati.>AorAg>n>ralAan>sth>siaAtoA6>>pAth>AchildAco@fortaCl>. ;hil>AcastingAt>chni7u>sA.ar$Aa@ongAorthop>dicAsurg>onsGAforAf>@urAfractur>sAth>AspicaA castAusuall$A>xt>ndsAfro@A@idBch>stAdownAth>Al>ngthAofAth>Aaff>ct>dAl>gAandAhalfwa$A downAth>Aoth>rAl>g.AO-hisAallowsAusAtoAC>stAcontrolAth>Afractur>AandA6>>pAitAfro@AshiftingA outAofAplac>GSA>xplainsA*r.ASch>r. AAAAAAAAAAAA 4igur>A2:AA(A$oungApati>ntAinAaAspicaAcastGAwhichAi@@oCili">sAth>Al>gAaft>rAr>align@>nt. %hildr>nAr>@ainAinAth>AspicaAcastAforAaAp>riodArangingAfro@AsixAw>>6sAtoAthr>>A@onths.A O aintainingAh$gi>n>AandA6>>pingAth>AchildAdistract>dAandAhapp$AcanAC>AaAchall>ng>AforA th>Apar>ntGSAsa$sA*r.ASch>r.AONow>.>rGSAh>AaddsGAOappli>dAcorr>ctl$AinAappropriat>l$A s>l>ct>dApati>ntsGAspicaAcastsAr>@ainAth>Asaf>stAandAl>astAco@plicat>dAwa$AtoAtr>atAth>s>A fractur>sAandAg>n>rall$A$i>ldA>xc>ll>ntAr>sults.S 4igur>sA&GA4:AATBra$AofAaAf>@urAfractur>AwithAspicaAcastAJtopKGAandA10A@onthsAaft>rAin/ur$A andAr>@o.alAofAspicaAcastAJCotto@K.AU%lic6AonAth>Ai@ag>sAtoA.i>wAinAaAlarg>rAsi">.V 4ollowingAtr>at@>ntGAth>Aorthop>dicAsurg>onAcontinu>sAtoA@onitorAth>Apati>ntAforAaAp>riodA ofAs>.>ralA$>arsAtoA>nsur>AthatAth>r>AisAnoAli@CAl>ngthAdiscr>panc$.AO;h>nAaAfractur>AinA th>AshaftAofAth>Af>@urAoccursGAth>ACon>At>ndsAtoAshort>nAatAth>ApointAwh>r>AitACr>a6sGA*r.A Sch>rA>xplains.AOLat>rAonGAasAh>alingAoccursAa@ongAchildr>nAinAthisAag>AgroupGAth>ACon>A t>ndsAtoAgrowAlong>rFAthisAisAaAph>no@>nonAcall>dAOo.>rgrowthSAthatA@a$AC>Acaus>dAC$A incr>as>dACloodAflowAtoAth>Afractur>Asit>.SA0nAso@>Apati>ntsAthisAinitialAshort>ningGA co@Cin>dAwithAth>AsuCs>7u>ntAincr>as>dAgrowthGAOcanc>lSAon>Aanoth>rAout.ANow>.>rGAinA thos>Acas>sAwh>r>AaAs@allAli@CAl>ngthAdiscr>panc$AoccursGAth>Aorthop>dicAsurg>onAcanAus>A aAr>lati.>l$Asi@pl>At>chni7u>GAsuchAasAgrowthA@odulationAofAth>Along>rAl>gGAtoAaddr>ssAthisA issu>. (g>A<AtoA10A$>ars L.>rAth>AlastAd>cad>A@an$Ap>diatricAorthop>distsAha.>Astart>dAusingAintra@>dullar$AnailsA orArodsA@ad>Afro@AstrongGAlightw>ightGAandAfl>xiCl>Atitaniu@AtoAstaCili">Af>@urAfractur>sA

inAchildr>nAag>dAfi.>AandAold>r.A0nAaAr>lati.>l$Asi@pl>At>chni7u>GAth>Aorthop>dicAsurg>onA @a6>sAtwoAs@allAincisionsABAaCoutAon>AinchAinAl>ngthABAonA>ith>rAsid>AofAth>A6n>>.A(ft>rA th>ACon>AisAr>align>dGAth>AnailsAar>Ains>rt>dAupAthroughAth>Ac>nt>rAofAth>ACon>Awh>r>Ath>$A actAasAanAint>rnalAsplintAduringAh>aling. 4igur>A<:AATBra$AshowingAfl>xiCl>Aintra@>dullar$AnailsAinAplac>.AU%lic6AonAth>Ai@ag>AtoA .i>wAinAaAlarg>rAsi">.V 0ntra@>dullar$AnailsAco@>AinAaArang>AofAdia@>t>rsAtoAacco@@odat>Ath>A.ar$ingAsi">AofA childr>nQsACon>s.AO8>n>rall$AnoAcastingAisAn>c>ssar$GSA*r.ASch>rAsa$sGAhow>.>rAaA6n>>A i@@oCili">rAisAco@@onl$Aus>dAforAaAf>wAw>>6sAtoApr>.>ntA@o.>@>ntAandAtoA6>>pAth>A childAco@fortaCl>.A0nA@ostAcas>sGAthr>>AtoAsixAw>>6sAofA>arl$Ah>alingAisAn>c>ssar$AC>for>A th>AchildAcanAC>ginAwal6ingAonAth>Ain/ur>dAl>g.A;h>nAth>ACon>AisAco@pl>t>l$Ah>al>dGA usuall$AaroundAon>A$>arAaft>rAth>Ain/ur$AoccursGAth>AchildAr>turnsAtoAth>AhospitalAtoAha.>A th>AnailsAr>@o.>d. O0ntra@>dullar$AnailsAar>Ausuall$A.>r$Aw>llBtol>rat>dGSAsa$sA*r.ASch>r.AO-h>$Aar>A particularl$Aus>fulAinAfi.>BAtoAt>nB$>arBoldAchildr>nAwhoAha.>AaAthic6AliningAaroundAth>A Con>Acall>dAth>Ap>riost>u@GAwhichA@ightAC>Ali6>n>dAtoAth>Ap>>lAonAaACanana.A-h>A p>riost>u@Ah>lpsA6>>pAth>ACon>A@or>AstaCl>AandAr>duc>sAth>An>>dAforAaAh>a.$AandArigidA d>.ic>GAsuchAasAthos>AthatA@ightAC>Aus>dAinAadults.S Lld>rAchildr>nAandAadol>sc>nts 0ntra@>dullar$AnailingAcanAalsoAwor6Aw>llAinAold>rAorAh>a.i>rAchildr>nGAt$picall$Athos>A o.>rAag>A10AandAh>a.i>rAthanA100ApoundsFAhow>.>rGAaAsingl>GAthic6>rGA@or>ArigidAnailAisA us>dArath>rAthanAth>As@all>rAfl>xiCl>Anails.A0nAth>s>Achildr>nGAth>AnailAisAins>rt>dAthroughA th>AtopAofAth>Af>@urGAn>arAth>AhipGAatAaApointAcall>dAth>Agr>at>rAtrochant>rGAandAloc6>dAintoA plac>AwithAaAscr>wAatAth>AtopAandAth>ACotto@AofAth>ACon>.A-hisAplac>@>ntAa.oidsA int>rruptionAofACloodAflowAtoAth>ACallAofAth>AhipA/ointGAwhichAcanAl>adAtoAdisaClingAarthritis.A -h>s>Aconc>rnsAar>AnotApr>s>ntAinAadultsAC>caus>Ath>$Aha.>Adiff>r>ntAanato@$.A0nAord>rAtoA @ini@i">Ath>Aris6AofAco@plicationsAwh>nAusingAintra@>dullar$AnailingAinAchildr>nGAth>A orthop>distAus>sAdiff>r>ntAd>.ic>sAandAt>chni7u>sAthanAth>$AwouldAus>AinAadultApati>nts. 4igur>A1:AATBra$AshowingAaArigidAintra@>dullar$AnailAinAplac>.AU%lic6AonAth>Ai@ag>AtoA.i>wA inAaAlarg>rAsi">.V SuC@uscularAplatingAisAanoth>rAtr>at@>ntAoptionAforAold>rAandAlarg>rAchildr>n.A0nAthisA proc>dur>GAusingAxBra$Ai@ag>sAforAguidanc>GAth>Aorthop>dicAsurg>onAins>rtsAaAstainl>ssA st>>lAplat>Aund>rAth>A@uscl>sAofAth>Al>gAandAacrossAth>Afractur>Asit>.A-hroughAs@allA incisionsAinAth>As6inGAscr>wsAar>Aplac>dAthroughAth>Aplat>AandACon>GAaCo.>AandAC>lowAth>A fractur>AtoAholdAitAinAplac>.A(lthoughAthisAt>chni7u>AisA@ini@all$Ain.asi.>GAr>@o.alAofAth>A plat>AisA@or>AdifficultAthanAr>@o.alAofAintra@>dullar$Anails.AO%urr>ntl$GAth>r>AisAso@>A discussionAongoingAinAth>Aorthop>dicAco@@unit$Ar>gardingAth>An>>dAtoAr>@o.>Ath>Aplat>sA atAallGSA*r.ASch>rAsa$s.

0nAadditionAtoAth>Aapproach>sAd>scriC>dGAth>AfallCac6Atr>at@>ntAforAaAf>@urAfractur>AinAan$A ag>AchildAisA>xt>rnalAfixation.A-hisAt>chni7u>Ain.ol.>sAth>Aus>AofArigidA@>talArodsAorA circularAringsAandApinsAins>rt>dAintoAth>ACon>AtoA@aintainAalign@>ntAduringAh>aling. -r>at@>nt -oAtr>atAaAchildIsAthighCon>Afractur>GAth>Api>c>sAofACon>Aar>Ar>align>dAandAh>ldAinAplac>AforA h>aling.A-r>at@>ntAd>p>ndsAonA@an$AfactorsGAsuchAasA$ourAchildIsAag>AandAw>ightGAth>A t$p>AofAfractur>GAhowAth>Ain/ur$Ahapp>n>dGAandAwh>th>rAth>ACro6>nACon>Api>rc>dAth>As6in. +onsurgicalA-r>at@>nt (A$oungAchildAinAaAhipAspicaAcastAtoAi@@oCili">AaAf>@oralAshaftAfractur>. %ourt>s$AofA->xasAScottishA)it>ANospital 0nAso@>AthighCon>Afractur>sGAth>AdoctorA@a$AC>AaCl>AtoA@anipulat>Ath>ACro6>nACon>sACac6A intoAplac>AwithoutAanAop>rationAJclos>dAr>ductionK.A0nAaACaC$Aund>rA1A@onthsAoldGAaACrac>A Jcall>dAaA#a.li6ANarn>ssKA@a$AC>AaCl>AtoAholdAth>ACro6>nACon>AstillA>noughAforAsucc>ssfulA h>aling. SpicaAcasting.A0nAchildr>nAC>tw>>nA'A@onthsAandA<A$>arsAoldGAaAspicaAcastAisAoft>nAappli>dA toA6>>pAth>Afractur>dApi>c>sAinAcorr>ctApositionAuntilAth>ACon>AisAh>al>d. -h>r>Aar>Adiff>r>ntAt$p>sAofAspicaAcastsGACutGAinAg>n>ralGAaAspicaAcastAC>ginsAatAth>Ach>stA andA>xt>ndsAallAth>Awa$AdownAth>Afractur>dAl>g.A-h>AcastA@a$AalsoA>xt>ndAdownAth>A unin/ur>dAl>gGAorAstopAatAth>A6n>>AorAhip.AWourAdoctorAwillAd>cid>AwhichAt$p>AofAspicaAcastA isA@ostA>ff>cti.>AforAtr>atingA$ourAchildIsAfractur>. WourAdoctorAwillAs>dat>A$ourAchildAforAth>Aclos>dAr>ductionGAandAappl$AaAspicaAcastA i@@>diat>l$AJorAwithinA24AhoursAofAhospitali"ationKAtoA6>>pAth>Afractur>dApi>c>sAinAcorr>ctA positionAuntilAh>alingAoccurs. (AthighCon>Afractur>AC>for>AandAi@@>diat>l$Aaft>rAtr>at@>ntAwithAaAspicaAcast.A-h>Af>@urA willAr>@od>lAo.>rAti@>AsoAthatAitAapp>arsAnor@al. ;h>nAaACon>ACr>a6sAandAisAdisplac>dGAth>Api>c>sAoft>nAo.>rlapAandAshort>nAth>Anor@alA l>ngthAofAth>ACon>.AB>caus>Achildr>nIsACon>sAgrowA7uic6l$GA$ourAdoctorA@a$AnotAn>>dAtoA @anipulat>Ath>Api>c>sACac6AintoAp>rf>ctAalign@>nt.A;hil>AinAth>AcastGAth>ACon>sAwillAgrowA andAh>alACac6AintoAaA@or>Anor@alAshap>. 0nAg>n>ralGAforAth>AC>stAr>sultsGAth>ACro6>nApi>c>sAshouldAnotAo.>rlapA@or>AthanA2Ac@Awh>nA inAth>Acast.A-h>AgrowthAofAth>AthighCon>A@a$AC>At>@poraril$Aincr>as>dAC$Ath>Atrau@a.A-h>A @ildAshort>ningAfro@Ath>Ao.>rlapAwillAr>sol.>. -raction.A0fAth>Ashort>ningAofAth>ACon>sAisAtooA@uchAJ@or>AthanA&Ac@KAorAifAth>ACon>AisAtooA croo6>dAinAth>AcastGAitA@a$AC>Ah>lpfulAtoAputAth>Al>gAinAaAw>ightAandAcount>rw>ightAs$st>@A JtractionKAtoA@a6>Asur>Ath>ACon>sAar>Aprop>rl$Ar>align>d. SurgicalA-r>at@>nt

*octorsAg>n>rall$Aagr>>AthatAdisplac>dAf>@urAfractur>sAthatAha.>Ashort>n>dA@or>AthanA&A c@Aar>AnotAacc>ptaCl>AandAr>7uir>Atr>at@>ntAtoAcorr>ctAatAl>astAaAportionAofAth>Ashort>ning. L>ftGA#r>op>rati.>ATBra$AofAaAchildAwithAaAfractur>AthroughAth>A@idshaftAofAth>Al>ftAf>@ur.A )ightGA#ostop>rati.>ATBra$AofAth>Asa@>AchildAshowsAthatAth>Afractur>AwasAtr>at>dAwithA int>rnalAfl>xiCl>AnailingAtoAr>stor>AstaCilit$AandAallowA>arl$A@oCili"ation. 0nAso@>A@or>Aco@plicat>dAin/uri>sGAth>AdoctorA@a$An>>dAtoAsurgicall$Ar>alignAth>ACon>A andAus>AanAi@plantAtoAstaCili">Ath>Afractur>. *octorsAar>Atr>atingAp>diatricAthighCon>Afractur>sA@or>Aoft>nAwithAsurg>r$AthanAinA pr>.iousA$>arsAdu>AtoAth>AC>n>fitsAthatAha.>AC>>nAr>cogni">d.A-h>s>Ainclud>A>arli>rA @oCili"ationGAfast>rAr>haCilitationGAandAshort>rAti@>Asp>ntAinAth>Ahospital. 0nAchildr>nAC>tw>>nA1AandA10A$>arsAoldGAfl>xiCl>Aintra@>dullar$AJinsid>Ath>ACon>KAnailsAar>A oft>nAus>dAtoAstaCili">Ath>Afractur>.AL.>rAth>ApastAd>cad>GAthisAtr>at@>ntA@>thodAhasA gain>dAgr>atAacc>ptanc>. Lccasionall$GAth>ACro6>nACon>AhasAtooA@an$Api>c>sAandAcanAnotAC>Atr>at>dAsucc>ssfull$A withAfl>xiCl>Anails.ALth>rAoptionsAthatAcanAl>adAtoAsucc>ssfulAoutco@>sAinAthisAsituationA includ>: AAAAXA(Aplat>AwithAscr>wsAthatARCridg>sRAth>Afractur>dAs>g@>nts AAAAXA(nA>xt>rnalAfixatorAYAthisAisAoft>nAus>dAifAth>r>AhasAC>>nAaAlarg>Aop>nAin/ur$AtoAth>A s6inAandA@uscl>s AAAAXA#rolong>dAtractionAwithAaApinAt>@poraril$Aplac>dAintoAth>AthighCon> 3xt>rnalAfixationAisAoft>nAus>dAtoAholdAth>ACon>sAtog>th>rAwh>nAth>As6inAandA@uscl>sAha.>A C>>nAin/ur>d. (sAth>AchildAn>arsAth>At>>nag>A$>arsAJ11A$>arsAtoAs6>l>talA@aturit$KGAth>A@ostAco@@onA tr>at@>ntAchoic>sAinclud>A>ith>rAfl>xiCl>Aintra@>dullar$AnailsAorAaArigidAloc6>dA intra@>dullar$Anail.A-h>ArigidAnailAisAparticularl$Aus>fulAwh>nAth>Afractur>AisAunstaCl>.A BothAt$p>sAofAnailsAallowAforAth>AchildAtoAC>ginAwal6ingAi@@>diat>l$. (ArigidGAloc6>dAintra@>dullar$AnailAisAoft>nAus>dAforAf>@urAfractur>sAinAadol>sc>ntsAwhoA ar>An>arl$AfullAgrown. -opAofApag> LongB->r@ALutco@>s 8>n>rall$GAchildr>nAwhoAsustainAaAthighCon>Afractur>AwillAh>alAw>llGAr>gainAnor@alA functionGAandAha.>Al>gsAthatAar>A>7ualAinAl>ngth.A-h>Aintra@>dullar$AnailsA@a$An>>dAtoAC>A r>@o.>dAfollowingAh>alingAifAth>$Acaus>AirritationAofAth>As6inAandAtissu>sAund>rn>ath. Lccasionall$GAchildr>nAwillAr>7uir>Afurth>rAtr>at@>ntGA>ith>rA>arl$AonAorAinAsuCs>7u>ntA $>arsGAifAth>$Aha.>AaAsignificantAdiff>r>nc>AinAth>Al>ngthAofAth>Al>gsGAunacc>ptaCl>A angulationAofAth>Ah>al>dACon>GAaCnor@alArotationAofAth>Ah>al>dACon>GAinf>ctionGAorAJrar>l$KA

ifAaAthighCon>Afractur>Ap>rsistsAJnonunionK. -h>s>AproCl>@sAcanAn>arl$Aalwa$sAC>Ar>sol.>dAwithAfurth>rAtr>at@>nt. Pe natalaksanaan 4raturACatangAf>@urAdit>rapiA@>nurutAusiaAdanAC>sarAana6GAs>iringc>d>raAZAc>d>raAt>rs>CutAs>p>rtiA c>d>raA6>palaAatauApolitrau@aGAatauta@pa6Aadan$aAl>siAt>rCu6aAd>nganAc>d>raA padaAp>@CuluhAdarahAdanAsaraf. # >n$>suaianAd>nganAp>ngoCatanAdanAfa6torAsosio>6ono@i6Aharusdip>rti@Cang6an.AJ1 ' K y A 4ra6turACatangAf>@urApadaAtahunAp>rta@aA6>hidupan # adaAp>riod>ApostnatalGAs>CuahACandag>As>d>rhanaAatauAharn>ssAdiguna6anuntu6ApanggulA displasti6Adiapli6asi6anAs>la@aAp>riod>AdariA2A@inggu.A-ra6siACilat>ralAo.>rh>adAt>lahA@>n/adiA pilihanAp>ngoCatanAuntu6As>la@aAC>C>rapatahun.A(na6A$angAdihospitalisasiAs>la@aA10AZA 14Atahun.A4ra6turAtrans.>rsalrataAZArataAs>@CuhAd>nganAp>@>nd>6anAJ shortening KAC>C>rapaA@illi@>t>r. # adaA6asusA6>curigaanAc>d>raAnonAaccid>ntGAhospitalisasiA@>@C>ri6an6>s>@patanAuntu6A @>ngin.>stigasiAsituasiAsosialAana6A A &4 y A 4ra6turACatangAf>@urApadaAusiaA1Asa@paiA4Atahun-ra6siA@asihAdiguna6anAs>caraAluasAuntu6A fra6turACatangAf>@urApadaAana6AZAana6ApraAs>6olahAdanAana6AtahunAp>rta@aAs>6olah.ANospitalisasiAs>la@aA 4AZA 1 A@ingguAdirasa6anAsudahA@>@adai.A-ra6siA6ulitAo.>rh>adAJ o v erhead skin traction KA@>@ili6iArisi6oAC>rupaA>f>6A$angA@>rugi6anApadaAsir6ulasi>6str>@itas.A-ra6siA6ulitAs>Cai6n$aA dipilihACahanA$angAhipoal>rg>ni6AJ>xG3lastoplastKAuntu6Apasi>nA$angAal>rgiAd>nganACahanA$angACiasaAatauA padaorangAtuaAdi@anaA6ulitn$aAt>lahArapuh.Kontraindi6asiAtra6siA6ulitA$aituACilaAt>rdapatA lu6aAatauA6>rusa6anA6ulitAs>rtatra6siAituGAituGA$angA@>@>rlu6anAC>CanAMA<A6g.A(6iCatAtra6siA6ulitA

$ang6>l>CihanAC>CanAdiAantaran$aAadalahAn>6rosisA6ulitGAoCstru6siA.as6ul>rGAo>d>@distalGA s>rtaAp>ron>alAn>r.>Apals$ApadaAtra6siAtung6ai y A 4ra6turACatangAf>@urApadaAusiaA<Asa@paiA1<Atahun*ila6u6anAp>@asanganA)uss>lAtra6siGAuntu6Atra6siAiniA dip>rlu6anA:A4ra@>GKatrolGA-aliG # l>st>r.A(na6AtidurAt>rl>ntangGAlaluAdipasangApl>st>rAdariACataslututGAdipasangAslingAdiAda>rahA poplit>aGAslingAdihuCung6anAd>nganAtaliGAdi@anataliAt>rs>CutAdihuCung6anAd>nganAC>CanAp>nari6.A5ntu6A @>@p>rsing6atAwa6turawatAs>t>lahA4A@ingguAditra6siGAcallusAsudahAt>rC>ntu6GAt>tapiAC>lu@A6uatAC>nar.A -ra6siAdil>pasA6>@udianAdipasangAgipAh>@ispi6a. Elastic intramedullar y nail atauAwa$>rAKirschn>rAintra@>ndularA6adangAdiguna6anAuntu6Afra6turAf>@urApadaA 6>lo@po6ApraAs>6olah.0ndi6asiAuta@aAadalahAgagaln$aAp>nangananAd>nganA@>ngguna6an s p ica cast. -itaniu@AnailAsC>rdia@>t>rAduaA@illi@>t>rAdi@asu66anAdariA@>dialdanAlat>ralA@>tafisisA dariAf>@urAdistalAuntu6A@>nstaCilisasiAintra@>dularAApadaAfra6tur.A;a6tuA6onsolidasiA r>lati.>Asing6atGAr>ntangAwa6tuAdariA2AZA<ACulanAt>rgantungApadaAusiaApasi>n.A0@plantA dicaCutApadaA&AZA 1 Culans>t>lahAp>@asangan.

Kons>r.atifA*ila6u6anApadaAana6Bana6AdanAr>@a/aAdi@anaA@asihA@>@ung6in6anA t>r/adin$ap>rtu@CuhanAtulangApan/ang.AS>lainAituGAdila6u6anA6ar>naAadan$aAinf>6siA ataudip>r6ira6anAdapatAt>r/adiAinf>6si.A-inda6anA$angAdila6u6anAadalahAd>nganAgipsA dantra6si. o A 8 ips 8 ipsA$angAid>alAadalahA$angA@>@Cung6usAtuCuhAs>suaiAd>nganC>ntu6AtuCuh.A0ndi6asiA dila6u6anAp>@asanganAgipsAadalahA: A 0@@oCilisasiAdanAp>n$anggaAfra6tur

 A 0stirahat6anAdanAstaCilisasi A Kor>6siAd>for@itas A >ngurangiAa6tifitas A >@CuatAc>ta6anAtuCuhAorthoti6AS>dang6anAhalBhalA$angAp>rluAdip>rhati6anA dala@p>@asanganAgipsAadalahA: A 8 ipsA$angApasAtida6Aa6anA@>ni@Cul6anAp>rlu6aan A 8 ipsApatahAtida6ACisaAdiguna6an A 8 ipsA$angAt>rlaluA6>cilAatauAt>rlaluAlonggarAsangatA@>@Caha$a6anA6li>n A 2 anganA@>rusa6A/A@>n>6anAgips A 2 anganAp>rnahA@>@asu66anAC>ndaAasingA6>Adala@gipsA/A@>nggaru6A

A A 2 anganA@>l>ta66anAgipsAl>CihAr>ndahAdariAtuCuht>rlaluAla@a o A -ra6siAJ@>ngang6at/@>nari6KS>caraAu@u@Atra6siAdila6u6anAd>nganA@>n>@pat6anAC>CanA d>ngantaliApadaA>6st>r@itasApasi>n.A->@patAtari6anAdis>suai6anAs>d>@i6ianrupaAs>hinggaA arahAtari6anAs>garisAd>nganAsu@CuApan/angAtulang$angApatah. >tod>Ap>@asanganAtra6siAantaraAlainA: A -ra6siA@anual-u/uann$aAadalahAp>rCai6anAdislo6asiGA@>ngurangiAfra6turGdanApadaA 6>adaanA>@>rg>nc$ A -ra6siA@>6ani6GAadaA2A@aca@A: A -ra6siA6ulitA*ipasangApadaAdasarAsist>@As6>l>talAuntu6Astur6tur$angAlainA@isalAotot.A *iguna6anAdala@Awa6tuA4@ingguAdanAC>CanAEA<A6g.

 A -ra6siAs6>l>tal >rupa6anAtra6siAd>finitifApadaAorangAd>wasaA$ang@>rupa6anACalanc>dAtraction.A*ila6u6anA untu6A@>n$>@purna6anAlu6aAop>rasiAd>nganA6awatA@>talA/p>n/>pitA@>laluiAtulangA/A /aringanA@>tal. A K>gunaanAp>@asanganAtra6siGAantaraAlainA: A A >ngurangiAn$>riAa6iCatAspas@>AototA A >@p>rCai6iAHA@>nc>gahAd>for@itas A 0@@oCilisasi A *ifra6siAp>n$a6itAJd>nganAp>n>6ananAuntu6An$>ritulangAs>ndiK A >ng>ncang6anApadaAp>rl>6atann$a A #rinsipAp>@asanganAtra6siA: A -aliAuta@aAdipasangAdiApinArang6aAs>hingga@>ni@Cul6anAga$aAtari6A A B >ratA>6str>@itasAd>nganAalatAp>n$o6ongAharuss>i@CangAd>nganAp>@C>ratAagarAr>du6siA dapatAdip>rtahan6an A #adaAtulangBtulangA$angA@>non/olAs>Cai6n$aAdiC>rilapisanA6husus A -ra6siAdapatAC>rg>ra6AC>CasAd>nganA6atrol

 A #>@C>ratAharusAcu6upAtinggiAdiAatasAp>r@u6aanlantai A -ra6siA$angAdipasangAharusACai6AdanAt>rasaAn$a@an A %araAop>ratif/p>@C>daha#adaAsaatAiniA@>tod>Ap>natala6sanaanA$angApalingA Can$a6A6>unggulann$aA@ung6inAadalahAp>@C>dahan. >tod>p>rawatanAiniAdis>CutAfi6sasiAint>rnaAdanAr>du6siAt>rCu6a.#adaAu@u@n$aAinsisiA dila6u6anApadaAt>@patA$ang@>ngala@iAc>d>raAdanAdit>rus6anAs>pan/angACidanganato@i6A @>nu/uAt>@patA$angA@>ngala@iAfra6tur. N >@ato@aAfra6turAdanAfrag@>nBfrag@>nAtulangA$angAt>lah@atiAdiirigasiAdariAlu6a.A4ra6turA 6>@udianAdir>posisiAd>ngantanganAagarA@>nghasil6anAposisiA$angAnor@alA 6>@Cali.S>sudahAdir>du6siGAfrag@>nBfrag@>nAtulangAini A dip>rtahan6anAd>nganAalatBalatAortop>di6AC>rupap>nGs>6rupGp>latGdanpa6u.K>untunganA p>rawatanAfra6turAd>nganAp>@C>dahanAantaralainA: A K>t>litianAr>posisiAfrag@>nAtulangA$angApatah A K>s>@patanAuntu6A@>@>ri6saAp>@CuluhAdarahAdansarafA$angAC>radaAdid>6atn$a A *apatA@>ncapaiAstaCilitasAfi6sasiA$angAcu6up@>@adai A -ida6Ap>rluA@>@asangAgipsAdanAalatBalatAstaCilisasi$angAlain A #>rawatanAdi ) SAdapatAdit>6anAs>@ini@alA@ung6inGt>ruta@aApadaA6asusB6asusA$angAtanpaA 6o@pli6asidanAd>nganA6>@a@puanA@>@p>rtahan6anAfungsis>ndiAdanAfungsiAototAha@pirA nor@alAs>la@ap>natala6sanaanAdi/alan6an