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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(02): 191-198
DOI: 10.1055/s-0042-1748815
Artigo de Atualização
Ortopedia Pediátrica

Fraturas na criança: Estamos ficando mais cirúrgicos?[*]

Article in several languages: português | English
Luiz Antônio Munhoz da Cunha 
1   Serviço de Ortopedia Pediátrica, Hospital Pequeno Príncipe, Curitiba, PR, Brasil
,
Mariana Demétrio de Sousa Pontes 
1   Serviço de Ortopedia Pediátrica, Hospital Pequeno Príncipe, Curitiba, PR, Brasil
› Author Affiliations Suporte Financeiro Não houve suporte financeiro de fontes públicas, comerciais, ou sem fins lucrativos.
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Resumo

Historicamente, as cirurgias no esqueleto imaturo eram reservadas às fraturas expostas ou articulares. Nos últimos anos, a melhora na qualidade e segurança das anestesias, novos equipamentos de imagem, implantes desenhados especialmente para fraturas pediátricas, associados à possibilidade de menor tempo de hospitalização e rápido retorno ao convívio social vêm demonstrando uma nova tendência de avaliar e tratar fraturas na criança. O objetivo deste artigo de atualização é responder às seguintes questões: (1) estamos realmente ficando mais cirúrgicos na abordagem das fraturas em crianças? (2) Caso isto seja verdadeiro, esta conduta cirúrgica está baseada em evidências científicas? De fato, nas últimas décadas, a literatura médica demonstra artigos que suportam melhor evolução das fraturas na criança com o tratamento cirúrgico. Nos membros superiores, isto fica muito evidente na sistematização da redução e fixação percutânea das fraturas supracondilianas do úmero e das fraturas de ossos do antebraço. Nos membros inferiores, o mesmo ocorre com fraturas diafisárias do fêmur e tíbia. No entanto, há lacunas na literatura. Os estudos publicados são geralmente com baixa evidência científica. Assim, pode-se deduzir que, mesmo sendo a abordagem cirúrgica mais presente, o tratamento de fraturas pediátricas deve ser sempre individualizado e conduzido de acordo com o conhecimento e experiência do médico profissional, levando em conta a presença de recursos tecnológicos disponíveis para o atendimento do pequeno paciente. Deve-se incluir todas as possibilidades, não cirúrgicas e/ou cirúrgicas, sempre instituindo ações baseadas na ciência e em concordância com os anseios da família.

Palavras-chave

cartilagem epifisial - fixação interna de fraturas - fraturas da placa de crescimento - fraturas ósseas - ortopedia - pediatria

* Trabalho desenvolvido no Hospital Pequeno Príncipe, Curitiba, PR, Brasil.




Publication History

Received: 06 November 2021

Accepted: 28 March 2022

Article published online:
10 June 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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