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¡¾2520¡¿Understanding different

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    The scene of the car accident was tragic, the teacher who protected the children died, and her sister Xiaoyu died of serious injuries. How could Shanshan survive alone?  It is for this reason that the doctor must be responsible for the child and be cautious in asking him to stay in the hospital for observation.

    We often describe children as saplings. What are the characteristics of saplings? The branches are easy to break but the skin is still attached. If the inside is broken, it is not obvious at first glance.

    Children¡¯s bones are really like this. Because the bones are tougher, more brittle, and have lower periosteum than adults, some children will have clinical phenomena like broken branches of small saplings.  This feature is called greenstick fracture and subperiosteal fracture in pediatric orthopedics. It is different from adult fractures and is unique to pediatrics.

    Like Shanshan, the doctor on site could not tell immediately whether she had hidden fractures.  She felt no pain, and her limbs were not obviously swollen. She needed to wait for the injury to further develop before she could show clinical symptoms.  After being sent to the hospital from the emergency scene, the doctor's routine was to take X-rays of her limbs suspected of severe trauma to rule out bone abnormalities.  After the film was taken, the X-ray report showed that the child had not just a simple skin injury, but a supracondylar fracture of the humerus.

    Where is the supracondyle of the humerus? To put it simply, it is in the patient¡¯s elbow area.

    Children¡¯s elbow joint injuries and fractures include supracondylar humeral fractures, lateral humeral condyle fractures, radial neck fractures, and proximal ulna fractures.  The most common one is supracondylar fracture of the humerus.

    Supracondylar fractures of the humerus are characterized by frequent skeletal deformity and ischemic forearm muscle contracture, referred to as volkmann contracture. This result can be imagined to be very serious and will turn into disability.

    People usually know the clinical treatment of fractures by manual reduction, that is, the orthopedic surgeon, like a martial arts master, magically breaks the patient's limbs back and forth, and then fixes them with plaster.  Sometimes orthopedic surgeons will inform patients and their families that surgical reduction is necessary if manual reduction cannot be achieved.  At this time, some people will question why people in my family and people in other families have the same fracture, so some do not need surgery and some need to go to the operating room.  Is it because I didn¡¯t send a red envelope and someone else gave a red envelope to the doctor?

    ¡°Whether the doctor has received the red envelope or not, I really don¡¯t dare to mess around with this kind of thing.  For this kind of matter, once the medical records are brought to court in a lawsuit, the doctor will not be able to take advantage of the situation.  The reason why there are huge and significant differences in treatment plans for the same disease is generally due to different classifications.  It is equivalent to saying that what ordinary people think is the same disease is not exactly the same in the eyes of doctors.

    Back to the supracondylar humerus fracture, it can be divided into extension type and flexion type according to whether the elbow joint is in a straight or flexed posture 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 straight type, there is no displacement and can be reduced manually without going to the operating room for treatment.  Shanshan has Type III, which is a severe displacement. It is difficult to ensure no recurrence with simple manual reduction. She needs to be combined with minimally invasive surgery to fix the fracture, and she can only go to the operating room.

    "This child said that she would not undergo surgery before seeing her sister." Liu Huaiyu said, "We have communicated with her parents several times for this reason and said that this surgery cannot be delayed."

    Children¡¯s orthopedic surgery must be done as early as possible, because children are in the growth and development stage, and fractures heal faster than adults.

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