The management of traumatic fractures in children.

Fractures in children require a specific treatment depending on age. While obstetric fractures usually heal well even in case of significant dislocations and conservative therapy, the proportion of operative interventions among all pediatric fractures is increasing with age. Though the vast majority of fractures in childhood are still treated non-operatively, a trend towards early operative interventions and cast-free mobilization has been noticeable in the recent years. The methods of operative stabilization differ between the respective age groups: While K-wire osteosynthesis and a minimal invasive approach using elastic stable intramedullary nailing (ESIN) are common in the group of school aged children, the use of external fixation and plate osteosynthesis has been accepted for the treatment of fractures in adolescents. Bioresorbable implants do not yet play a decisive role in the management of pediatric fractures. This review is focusing on the current indications and concepts for stabilization of frequent pediatric fractures.