[Biological osteosynthesis in children and adolescents].
Minimally invasive osteosynthesis techniques are very suitable for treatment of unstable fractures in children. Because of little additional soft tissue trauma, these techniques are also called biological osteosynthesis. They allow fracture treatment in children and adolescents without any harm to the growth plate. Angular deformities can be corrected due to further growth. Kirschner wires, threaded or unthreaded, elastic intramedullary rods or external fixators are most commonly used for osteosynthesis. After successful closed reduction of the fragments under x-ray amplifier control, the implants are inserted with minimal trauma to the soft tissues. This results in safe and rapid healing, spontaneous correction of slight malunions and fast restoration of function. The main disadvantage of these methods is a greater exposure of the patient and in particular the surgical team to x-ray radiation. These techniques result in shorter hospital stays enabling a fast return to a familiar environment. However high standard technical equipment and an experienced treating team are required for success.