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Abstract：
In this paper, authors introduce the basic prerequisite for rational, targeted, and above all, child-oriented diagnosis of fractures and dislocations in children and adolescents is in-depth prior knowledge of the special features of trauma in the growth age group. This review summarizes the authors\' many years of experience and the state of the current pediatric traumatology literature. It aims to provide recommendations for rational, child-specific diagnostics appropriate to the child, especially for the area of extremity injuries in the growth age. The plain radiograph remains the indispensable standard in diagnosing fractures and dislocations of the musculoskeletal system in childhood and adolescence. Plain radiographs in two planes are the norm, but in certain situations, one plane is sufficient. X-rays of the opposite side in acute diagnostics are obsolete. Images to show consolidation after conservative treatment is rarely necessary. Before metal removal, however, they are indispensable. The upcoming diagnostical tool in pediatric trauma is ultrasound. More and more studies show that in elected injuries and using standardized protocols, fracture ultrasound is as accurate as plain radiographs to detect and control osseous and articular injuries. In acute trauma, CT scans have only a few indications, especially in epiphyseal fractures in adolescents, such as transitional fractures of the distal tibia or coronal shear fractures of the distal humerus. CT protocols must be adapted to children and adolescents to minimize radiation exposure. MRI has no indication in the detection or understanding of acute fractures in infants and children. It has its place in articular injuries of the knee and shoulder to show damage to ligaments, cartilage, and other soft tissues. Furthermore, MRI is useful in cases of remaining pain after trauma without radiological proof of a fracture and in the visualization of premature closure of growth plates after trauma to plan therapy. Several everyday examples of rational diagnostic workflows, as the authors recommend them, are mentioned. The necessity of radiation protection must be taken into consideration.
摘要：
在本文中,作者介绍了理性的基本前提，有针对性的,最重要的是,以儿童为导向的儿童和青少年骨折和脱位的诊断是对成长年龄组创伤的特殊特征的深入先验知识。这篇综述总结了作者多年的经验和当前儿科创伤学文献的状况。它旨在为理性，适合儿童的儿童特异性诊断，特别是对于生长年龄的四肢受伤区域。X线平片仍然是诊断儿童和青春期肌肉骨骼系统骨折和脱位不可或缺的标准。两个平面的普通射线照片是常态，但在某些情况下,一架飞机就足够了。急性诊断中相反侧的X射线已过时。很少需要显示保守治疗后巩固的图像。金属去除前,然而,它们是不可或缺的。即将到来的儿科创伤诊断工具是超声。越来越多的研究表明，在选择伤害和使用标准化的协议中，骨折超声与X线平片一样准确，可以检测和控制骨和关节损伤。在急性创伤中，CT扫描只有几个适应症,尤其是在青少年的骨epi骨折中，如胫骨远端过渡性骨折或肱骨远端冠状剪切骨折。CT方案必须适应儿童和青少年，以尽量减少辐射暴露。MRI在检测或了解婴儿和儿童的急性骨折方面没有指征。它在膝盖和肩膀的关节损伤中有它的位置，以显示对韧带的损伤，软骨，和其他软组织。此外，MRI在创伤后仍有疼痛而没有放射学证据的情况下有用骨折，以及在创伤后计划治疗后生长板过早闭合的可视化中有用。合理诊断工作流程的几个日常例子，正如作者推荐的那样，被提及。必须考虑辐射防护的必要性。
