1. Các phương pháp điều trị

a. Nguyên tắc

– Điều trị phải được thực hiện càng sớm càng tốt vì cal xương mọc rất nhanh.

b. Điều trị bảo tồn: (là phương pháp chủ yếu)

Các pp điều trị bảo tồn gồm: bó bột, nẹp bột, đai, nẹp vải, băng thun…

Nguyên tắc của điều trị bảo tồn:

– Nắn chỉnh các di lệch và bất động cho đến khi có cal xương.

– Nắn hết di lệch xoay.

– Bó bột phải qua hai khớp trên và dưới của ổ gãy (chú ý chèn ép bột).

– Thời gian bất động thường ngắn hơn so với người lớn.

– Phần lớn gãy xương ở trẻ em được điều trị bảo tồn.

– Tập vật lí trị liệu theo chỉ định của thầy thuốc

c. Điều trị phẫu thuật:

Chỉ định

– Điều trị bảo tồn thất bại.

– Gãy phạm khớp có di lệch.

– Gãy xương hở.

– Gãy bị di chứng di lệch xoay.

– Gãy có kèm chèn ép khoang; tổn thương mạch máu, thần kinh…

2. Phòng bệnh

– Ở trẻ dưới 3 tuổi:

Luôn được trông giữ kể cả khi bé ngủ, không thực hiện các động tác nguy hiểm, dễ gây cho trẻ bị rớt: như xốc ngược, tung hứng bé…

– Trẻ từ 4-8 tuổi:

Nơi trẻ đi lại, vui chơi phải có đủ ánh sáng.

Không khuyến khích trẻ leo trèo như cột điện, mái nhà…

Tránh cho trẻ tiếp xúc những đồ vật quá, vật sắt nhọn…dễ gây thương tích và chấn thương.

– Trẻ trên 9 tuổi:

Dạy cho trẻ biết phòng tránh các nguyên nhân tai nạn: Té, ngã, vết thương, chấn thương…

Không được cho trẻ leo trèo cột điện, mái nhà, không chạy thả diều trên sân thượng hay lòng lề đường.

Trong các dịp nghỉ, hướng dẫn và tổ chức cho trẻ các hoạt động vui chơi tập thể có hướng dẫn viên…

– Ngoài ra, nên xây dựng môi trường an toàn, vận động mọi người làm các sân chơi an toàn cho trẻ, như lắp đặt những biển báo hiệu nguy hiểm, biển báo cấm đi, cấm leo trèo ở những nơi cần thiết.

Thực hiện mô hình ngôi nhà an toàn cho trẻ như: các vật cứng đượ bao che lớp nhựa mềm, song chắn, rào chắn ở các cửa sổ, ban công, các cửa đi ra sân vườn nếu có các bậc thềm cao…



Hình 1. Trước và sau bó bột trong “Gãy kín 1/3 giữa xương chày (P)”
(nguồn: khoa Ngoại Nhi, Bệnh viện Sản Nhi An Giang).


Hình 2. Trước và sau kết hợp xương trong “Gãy kín trên 2 lồi cầu xương cánh tay (P)”
(nguồn: khoa Ngoại Nhi, Bệnh viện Sản Nhi An Giang).


Hình 3. Trước và sau bó bột trong “Gãy kín đầu dưới 2 xương cẳng tay (T)”
(nguồn: khoa Ngoại Nhi, Bệnh viện Sản Nhi An Giang).


Hình 4. Trước và sau kết hợp xương trong “Gãy kín lồi cầu ngoài xương cánh tay (P)”
(nguồn: khoa Ngoại Nhi, Bệnh viện Sản Nhi An Giang).


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