Conservative treatment of the clavicle fracture of children

小児の鎖骨骨折は臨床的に診られる骨折である．多くは介達外力で発生する．不全骨折が多いが，完全に転位する例もある．小児の骨はリモデリングが旺盛である．そのため保存的治療が原則で，三角巾固定やクラビクルバンドの装着で対応することが多い．リモデリングが期待できるため徒手整復はほとんど必要ないとされている．本研究では小児鎖骨骨折の特徴や治療法を確認の上，診療で行われた保存的治療の症例を紹介し，今後の小児鎖骨骨折における施術のあり方について検討する．今回の症例では骨片転位の大きさの違いによって仮骨の出現時期や骨硬化など治癒経過に差はあるものの，最終的に骨癒合が認められた．今後も小児骨折の特徴を把握しながら，自家矯正力の限界や成長障害の可能性を見極め，慎重に対応していくことが必要だと考える．
Clavicle fracture is one of the most frequent fractures seen clinically, so we often choose conservative treatment. Most of clavicle fractures occur with indirect force resulting in many incomplete breaks. A triangular bandage and a clavicle band are used when the bone is fixed. Remodeling is expected, so, closed reduction operations are commonly not required. We confirm characteristics of conservative treatment for clavicle fracture of children in this study and refer to a case of the conservative treatment performed in practice. Then, we examine a method of the conservative treatment in the clavicle fracture of children for the future. Synostosis was found although there was a difference in a healing process. The results confirmed remodeling worked well in the first case. Generally, prognosis of child bone fracture was good. However, it is necessary to treat them carefully, being aware of the limit of remodeling potency and keeping a close watch for Dystosis.