Won't somebody think of the children?

It's not that often that one finds one's orthopaedic practice stimulated by The Simpsons, but here it is:

 

 They're not just little adults are they, as the anaesthetists keep telling us that, but I have to say I think it's a bit overdone - with lots of exceptions obviously. However, the subspecialisation of paediatric orthopaedics has been extended into a lot of really pretty straightforward children's trauma. In my view this has lead to a certain amount of potentially unnecessary operating.

Twenty years ago there was actually very little quality literature on fracture remodelling. There's more now, and the oldtimers' claim that you can rely on remodelling in lots of situations seems to me to be mainly true. Again, I don't mean specific potentially problematic injuries like in late teens, displaced intra-articular fractures and so on, but there has been a tendency to overcook the interventions (personal opinion, I accept). Which I think fits with the title of this must-read paper from Nottingham. (The paper references the great Mercer Rang, one of the wittiest and best writers in the history of orthopaedics, of whom more in another post)