Principles of fracture remodeling in children

Kaye E. Wilkins

Research output: Contribution to journalArticle

78 Scopus citations

Abstract

In treating fractures in children, the surgeon must have a good knowledge of the three phases of bone healing, ie, inflammatory, reparative, and remodeling and understand how they contribute to the final recovery of the fracture healing process. By and large, the ability to remodel depends on the bone involved, the patient's age, the proximity to the joint, and its orientation to the joint axis. In the typical long bone, 75% of the remodeling occurs by reorientation of the physis while appositional remodeling of the diaphysis can only be expected to contribute 25% to the remodeling process. The various values of acceptable alignment for each of the major fracture patterns are outlined. These serve only as guidelines. The patient's functional capacity and the surgeon's experience should also be factors in determining whether to depend on the remodeling capacity of the specific fracture or to consider performing a more aggressive, invasive technique to achieve a satisfactory result. There are two advantages in treating children's fractures. First, the healing process is very rapid. Nonunion is a rare event in the pediatric age group [20]. The second perk is that there is a very good remodeling capacity should there be less than anatomical alignment of the affected bone once the fracture has healed. Any individual treating fractures in the pediatric age group should fully understand how pediatric fractures heal and how the remodeling process occurs.

Original languageEnglish (US)
Pages (from-to)S-A3-S-A11
JournalInjury
Volume36
Issue number1 SUPPL.
DOIs
StatePublished - Feb 1 2005

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Keywords

  • Biology of fracture healing
  • Child
  • Fracture remodeling
  • Healing

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine

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