没必要开放复位
牵引固定后不要活动1个月自己愈合
手术是没有必要的。功能锻炼可以开始了。但外固定保护是否去除要看患儿的依从性。不完全限制腕关节的夹板固定是比较好的选择。
我有个同学的小弟，很顽皮，类似本例的骨折。手法复位外固定，一月去除夹板，第二天他玩球就又摔断了。后来我给他上了2个月夹板。实在不听话。现在功能正常。
刀是不用开的.
问一下楼主是哪个医院的吕军浩啊?
不要手术
不要担心啊 功能没问题
去除石膏，功能锻炼，以免骨折端的肌腱粘连
这个涉及一个功能复位的概念问题
按照教科书，上肢，前后方向，10度的成角是不影响功能的，此例应
属于功能复位的范畴，就此片而言，个人认为是没有必要手术的
按此愈合后，功能应该没有问题
不用开刀，改用夹板固定就行了
骨折已四周，可拆除石膏外固定，看旋转功能，应该不会有影响，本人曾遇到过类似的情况，专家看的，成角比这还大，专家说随着骨骼塑形生长发育，不会影响旋转功能。固建议不用手术。
同意江湖郎中版主的意见，不用开刀
我认为不用开刀，也无需手法整复。旋前应该不收影响，旋后要差些，但小儿有较强的塑形能力，通过功能活动预后要好。
完全可通过自身的塑形全部恢复功能,一年后不会有任何畸。
不需要手术，理由如下：（1）受伤已经4周，骨折断端以稳定，若再切开复位内固定，必然再次造成新的骨折，不利于骨折愈合。（2）患者10岁，塑性能力很强，从正位X线片看桡骨力线正常，侧位片示骨折断端向背侧成角不超过30度，将来完全可恢复前臂力线，不会影响前臂旋转功能。
不需要手术，理由如下：（1）受伤已经4周，骨折断端以稳定，若再切开复位内固定，必然再次造成新的骨折，不利于骨折愈合。（2）患者10岁，塑性能力很强，从正位X线片看桡骨力线正常，侧位片示骨折断端向背侧成角不超过30度，将来完全可恢复前臂力线，不会影响前臂旋转功能。
先请教大家个问题:儿童是否存在盖氏骨折?
以前的书籍文献中认为不存在儿童盖氏骨折,积医荣国威主编骨折一书中阎桂森医师编写了这部分内容.值得商榷.
按骨折一书49章六治疗部分的手术治疗指征:该病例无需手术.复诊时应关注下尺桡关节的影象.
我个人认为不用手术，夹板固定三周，加之功能练习，因为儿童儿童塑形能力强，成角可以在以后的生长中自行纠正，这个角度不至于产生肌腱损伤。此病例提示我们：写好门诊病例，做好交代，及时随诊。我遇见一例，根本病差不多，同事说交代及时随诊，家属说医生叫一个月复查，听邻居说要勤复查我们才来的（此时正好二十天），最后做了从新手法整复甲板国定，成角基本消失，家属曾经来院找了几次（因费用），最后不了了之。
没必要开刀
小孩塑性强
应该不会影响功能。
注意复查X片
没有任何必要,一年后骨折处完全可恢复正常.
骨折已4周,拆除石膏行功能锻炼。儿童骨折,成角不大,且与关节活动方向一致,即使是新鲜的也无需手术 ，我自己小时候就骨折过，未行复位，后来半年内一直有畸形、疼痛，一年后就完全恢复了。
应手术治疗
简单一句话 不开刀~
这是摘自Fracture in children Fifth edition 中的关于前臂骨折的内容:Spontaneous correction of residual angulation can occur in children. The amount of correction depends on age, the distance from the physis, the severity of deformity, and the direction of angulation. Greater degrees of correction can be expected in younger children and in more distal fractures (11,24,38,54,89,139,153). Onne and Sandblom observed that during the first decade of life, the shafts of the forearms have an excellent capacity of correcting angulation up to 20 degrees spontaneously (89). Others have confirmed this remodeling potential (38,50,79,95,96,123,139). The capacity for remodeling diminishes after the age of 10 years. Angulation of more than 10 degrees after the age of 10 years is unlikely to remodel
From a functional standpoint, Carey et al. (15) noted that patients older than 10 years of age might have residual changes on radiographs without a commensurate loss in range of motion. They reported on nine patients, 11 to 15 years of age, with an average angulation of 13 degrees (range, 5–30 degrees). Five of the nine patients lost forearm rotation ranging from 20 to 35 degrees, but none had functional deficits. They concluded that none of these patients would have been better off with open reduction. Thomas et al. (123) reviewed 65 malunions in children up to age 15 years and concluded that up to 15 degrees of angular deformity is acceptable because the final loss of function is negligible. When treating forearm fractures, the clinician should consider the statement by Hey Groves that “art should secure supination and nature be trusted to secure pronation” (48). A supination loss cannot be compensated well by adduction at the shoulder, but a pronation loss can be masked by abduction at the shoulder
Recommendations for acceptable reduction vary. Moesner and Ostergaard (79) stated that children younger than 9 years of age with angulation of less than 20 degrees will regain full range of motion and 90% remodeling. This conclusion has been supported by Carey et al. (15) and others (54,89,39). However, Blount (10) cautioned, “fractures of the middle third of the forearm should not be allowed to remain angulated to any appreciable degree except in very young children.” Daruwalla (24) concluded that after age 6 years, remodeling is unlikely to correct a deformity of more than 10 degrees. Daruwalla believed that angulation of 15 degrees is acceptable in children younger than 5 years. Hogstrom et al. (50) noted that young children have a good chance of achieving correction of angular deformity, but concluded that all deformities exceeding 10 degrees should be corrected because it is impossible to predict remodeling. Price et al. (95,96) concluded that 10 degrees of angulation, complete displacement, and loss of radial bow can be accepted rather than resorting to open reducti
没有必要再手术,应拆除石膏,功能锻炼,随着生长发育应该有所改善.
儿童的塑型能力强,应该对以后的功能没多大影响.还是保守治疗.
从正位X片看，桡骨无侧方移位成角畸形，侧位片看桡骨向背侧移位成角小于30度，患者10岁，将来完全可以塑性至正常，可以继续石膏固定，不要手术，也不要闭合复位，因为受伤已经4周，骨折断端已经稳定。
此骨折可保守治疗！
我认为不用开刀，前段时间我们有同类病号，预后不错，但一定要讲清楚后签字，讲清手术与石膏托固定的利弊！
不必手术，很好的功能对位啦！
不用开刀,我觉得楼主是很容易理解的,关键是患儿的家属,怎么向他们讲清楚是本病的关键.
从片上看桡骨下三分一骨折,向背侧稍成角,骨折愈合后应该不会留前臂畸形及影响功能,要说影响,可能早期前臂旋转稍受限,但患者年龄小,应该会塑形的,因此不必开刀.建议现在改用小夹板固定,让患者有意识地主动用力地背伸右腕关节,也可能一、两个月后复查照片时桡骨成角处已经矫正.
为什么这么多战友异口同声的认为是陈旧性骨折？
患者不是受伤后1周来就诊的吗？
建议行夹板固定，一可早期行功能锻炼，已防关节僵硬，二可以朔行纠正畸形，不要用石膏，发挥中医特色／／
不用开刀，也无需手法整复。小儿有较强的塑形能力。以后功能会恢复很好
