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开放性骨折指骨折断端或骨折血肿与外界环境相通的骨折,是儿童较严重的高能量损伤,主要由交通事故及高空坠落所致.治疗原则包括及时清创与抗生素的使用、骨折复位与固定及早期软组织覆盖等.骨折复位与固定是治疗儿童开放性骨折的中心环节,临床常用的固定方法有:医用夹板、牵引、克氏针、接骨板、髓内针髓内固定及外固定支架等.对于儿童开放性骨折治疗方法的选择一直存在争议,选择外固定或内固定,常为临床医师遇到儿童开放性骨折时的两难选择.本文对儿童不同部位的开放性骨折固定方式的选择进行文献回顾.“,”Open fracture is considered to be a fracture due to high energy that the fracture fragments or the fracture heamatoma communicate with the outside environment.Treatment principles of open fractures in children are what mentioned before as prompt debridement and antibiotic administration,reduction and stabilization of the fracture,and wound closure and dressing at an appropriate stage.The reduction and stabilization of fractures occupies an extremely important position due to roles of promoting bone healing and rehabilitation,easing pain,protecting the surrounding soft tissues,avoiding a secondary neurovascular injury,boosting growth potential,and so on.The essential difference compared to adults is that surviving periosteum has a spectacular ability to regenerate bone in young children even there is considerable quantity of bone loss when reliable reduction and fixation is achieved.The alternative means are orthopedic splints,traction,internal fixation by plates and screws,intramedullary nails,and external fixation.The location of the fracture,the position and condition of the wound and the physiological status of the child must be taken into consideration while choosing an optimal mode of fixation.