Fractures of the upper limbs are frequent and often need operative treatment in addition to a well-indicated conservative management. This depends on the maturity of the nearest growth plate and the local remodeling potential, which is dependent on age. Following conventional x‑ray imaging an individual prognostic growth analysis leads to the therapeutic decision. Around the elbow and the shaft of the forearm, criteria are stricter than near the shoulder or wrist. Gilchrist or Desault bandages as well as braces are adequate for most subcapital and humeral shaft fractures. The short forearm cast is the method of choice at the wrist. In the case of osteosynthesis the elastic stable intramedullary nailing (ESIN) method is the first choice for subcapital humerus, radial neck and shaft fractures. Screw fixation is usually carried out for epicondylar and condylar fractures and for supracondylar and wrist fractures K‑wires represent the standard procedure.
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