Description
This presentation revolves around the management of adolescent fractures, highlighting the importance of having a comprehensive skill set for treatment. The speaker, Jeff Yach, emphasizes that practitioners treating adolescent fractures should be proficient in closed management, intramedullary nailing, and plating techniques. He discusses the diversity in fracture patterns, growth potential, and the implications for treatment planning. Yach notes the significance of having multiple methods available, likening the scenario to having various tools in a toolbox, asserting that the approach should be tailored to each unique case.
Given the inherent variability in fracture cases, he urges clinicians to choose the optimal treatment strategies while also recognizing when to seek assistance if they lack expertise in a particular technique. The discourse touches upon the functional outcomes and cosmetic considerations of different surgical approaches, specifically intramedullary nailing versus plating, indicating that both can yield high union rates but differ in patient concerns regarding scars and recovery.
Yach provides insights into the technical aspects of plating and recommends compression plating for better union rates and quicker return to activities. He discusses the advantages of plating, especially in cases of axially unstable fractures, and encourages best practices in choosing plate sizes based on the patient's specifications. He concludes by noting that hardware removal is not standard practice unless medically required, prioritizing the management of hardware-related symptoms and family wishes.