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  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, and the broken inside is not obvious at first glance.

  The bones of children are really like this. Because the bones are more ductile and brittle than adults, and the thickness of the periosteum is low, some children will have clinical phenomena like broken branches of small saplings. This feature is called greenstick fracture subperiosteal fracture in pediatric orthopedics, which is different from adult fracture and is unique to pediatrics.

  Like Shanshan, the doctors at the scene couldn\'t immediately tell if she had a hidden fracture. She herself does not feel pain, and there is no obvious swelling in her limbs. She needs to wait for the further development of the injury to show clinical symptoms. From the emergency scene to the hospital, doctors routinely had to film her limbs suspected of serious trauma to rule out bone abnormalities. After the film was taken, the X-ray report showed that the child was not a simple skin trauma, but had a supracondylar fracture of the humerus.

Where is the    supracondylar of the humerus, which is simply the patient\'s elbow area.

  Injured fractures of the elbow joint in children include supracondylar fractures of the humerus, lateral humeral condyle fractures, radial neck fractures, and proximal ulna fractures. The most common genus and number one is the supracondylar fracture of the humerus.

   Supracondylar fractures of the humerus are characterized by frequent skeletal deformities and ischemic muscle contractures of the forearm referred to as Volkmann\'s contractures.

  In clinical treatment of fractures, the common people usually know the manual reduction, that is, the orthopaedic surgeon, like a martial arts master, performs a magical way of breaking the patient\'s limb back and forth, and then uses a plaster to fix it. Occasionally, the orthopedic surgeon will inform the patient and family that the manual reduction cannot be performed and requires surgical reduction. At this time, some people will question, how my family and his family, some of the same fractures do not need surgery, some need to go to the operating room. Is it because I didn\'t give red envelopes and others gave red envelopes to doctors.

  Did the doctor really dare not mess around with this kind of thing if he received a red envelope. Because of this kind of thing, as soon as the medical records are brought to court, the doctor can\'t eat and walk around. The reason why there are huge and significant differences in the treatment of the same disease is generally due to different types. It is equivalent to saying that what the common people think is the same disease is not entirely true in the eyes of doctors.

   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 a straight or flexed position when the patient is injured. The former accounts for 90% of cases in children. Among them, the extension type is divided into three types according to the degree of fracture displacement. Like the type I straight type, there is no displacement, and the manual reduction can be done, and there is no need to enter the operating room for treatment. Shanshan is type 3, which belongs to severe displacement. It is difficult to ensure no recurrence with simple manual reduction. The fracture needs to be fixed with minimally invasive surgery, and she can only enter the operating room.

   "The child said that she didn\'t have surgery before she saw her sister." Liu Huaiyu said, "We have communicated with her parents several times for this reason, saying that the surgery will not be delayed."

   Children\'s orthopedic surgery must be done as soon as possible, because children are in the stage of growth and development, and fractures heal faster than adults.

   (end of this chapter)