There are several treatment options. In children with a completely non-displaced fracture (i.e. the bone fragments have not moved), children will usually be treated in a cast without surgery. In children where the fragment of<unk><unk>  is trapped in the joint, or where the elbow is dislocated and can’t be readily reduced in the emergency department, then there is universal agreement that surgery is needed to realign the bones. In children with a displaced fracture without a dislocation (or a dislocation that has been reduced), there is debate amongst surgeons about the best approach to treatment. Half of surgeons routinely recommend surgery, and half routinely recommend against surgery. The debate is whether to realign the displaced bones back into their natural position with surgery, and hold the fragments of bone with wires or screws, or whether to allow the fragments to heal in their current position by resting the elbow in a cast. Studies that have sought to draw together all of the scientific evidence, have failed to arrive at any firm conclusion, either in support of surgery or against surgery. Some point to good to results without surgery, whilst the others conclude that surgical fixation should be strongly considered to achieve maximise the function in these children. However, the current published research has serious methodological limitations, particularly with regard to inconsistent follow-up, no standardisation of treatment approaches, the infrequent use of patient reported outcomes, and selection bias amongst those selected to undergo operative fixation.
Medial epicondyle fracture of the humerus
Supracondylar humerus fracture
Proximal humerus fracture
Radial head fracture
Distal humeral fracture
Trimalleolar fracture
Scapular fracture
Scaphoid fracture