There was a time when operative management of fractures in children was unthinkable. But with evolution of orthopedics, more and more fractures see increased operative management.
There are certain reasons for that. One of the main reasons that improvement in surgical techniques no more require large incisions and extensive dissection as it used to be.
Image intensifier has greatly improved the ease with which fractures can be reduced and stabilized internally with percutaneous methods. Modern instrumentation greatly facilitates the accuracy and thus better results.
Children tolerate all types of casts well for short periods of time, which allows a minimally stabilized fracture to be immobilized with a cast until there is sufficient internal callous.
Moreover, operative intervention means shorter stay at hospital and lesser cost. For social reasons [Job pressure, family needs] parents want an earlier discharge from the hospital.
With modern parents is another aspect that needs to be discussed. They want perfect results.These expectations often direct the treating physician toward operative intervention.
In some fractures like supracondylar fracture of humerus, the operative results are better than non operative results.
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