[Treatment of closed fractures in children].

The principles of treatment of bone fractures in children differ from those in adults and are determined by the morphofunctional features of the growing and developing child organism: the anatomo-physiological peculiarities of the structure and blood supply of the bone of a child, the high regenerative possibilities, the capability for self-correction of some types of residual displacement during growth. Peculiar types of bone injuries occur in childhood which are not encountered in adults. These are subperiosteal linear and folded fractures, fractures of the green stick type, damage to the growth zones (epiphyseolysis and osteo-epiphyseolysis), etc. The localization of the fracture and the size (degree) of displacement of the fragments are very important in the choice of the therapeutic tactics. Predominantly qualitative appraisal of the displacement suffices in metaphyseal and diaphyseal fracture and in injury to the growth zones (extra-articular fracture). Quantitative appraisal of the size of the displacement is advisable in intra-articular fractures, for which the techniques are suggested. Four degrees of fragment displacement are distinguished. Depending on the localization and character of the fracture and the size of the displacement of the fragments, conservative, active surgical, and operative therapeutic tactics may be chosen according to strictly differentiated indications. Each of them includes various methods of fracture management.