Government orthopaedic departments can handle birth fractures adequately
A Chinese weekly magazine recently published an article on birth fractures in babies. It delivered a message that suggested such injuries cannot be adequately handled by orthopaedic departments in the government hospitals, because they do not have paediatric orthopaedic specialists.
“This is a very unfair suggestion”, says Dr. Louis Hsu, a senior orthopaedic surgeon with a special interest in children’s orthopaedics. Government hospitals have been handling these fractures for over half a century; since the inception of orthopaedic service in Hong Kong. Fractures in babies are quite simple to handle and do not need the services of a paediatric orthopaedic surgeon. Baby fractures heal very easily; and the fractures can be allowed to heal with angulations because the baby’s growth will automatically realign the fracture. So there is no pressure to maintain the fracture in good alignment. And even when the fracture heals with severe angulations mother-nature will always straighten the bone automatically and correct any length discrepancy that may have occurred.
Treatment is usually by some form of splintage and surgery is almost never necessary. The choice of splint does not really matter. The most important aspect is to know how to handle the child. Understanding and care are required. Understanding of how the fracture heals and what causes pain or discomfort; and care to ensure the limb is placed in a comfortable position.