Author/Editor		Slamnik, Mihaela; Čretnik, Andrej
Title		Zlomi pri otrocih
Type		članek
Source		Med Mes
Vol. and No.		Letnik 4, št. 3-4
Publication year		2008
Volume		str. 98-104
Language		slo
Abstract		Injuries are the most frequent cause of death and disability, particularly in the young population. Children's fractures are specific in many ways. The unique anatomy of children's bones (growth plates and plasticity) leads to the fracture patterns not seen in adulthood. Children's bones can resist even greater than adult's ones, but growth plates are two to threetimes more sensitive to injuries. Growth plates are made of hyaline cartilage and are responsible for the growth of a bone. When the children's growth is stopped (from 16-20 yrs) growth plates are substituted with the bone. Growing potential of children's bone has good and bad sides. A growing bone, which has deformed after a fracture, can be remodelled and straightened by itself over time. Typical fractures not seen in adulthood are: greenstick fractures, buckle (torus) fractures and growth plate fractures. Growth plate fractures are divided according to the Selter-Harris into five categories. Treatment of growth plate injuries depends on the type of injury. In all cases, treatment should be started as soon as possible after the injury and will generally involve: analgesia, immobilisation, reposition or surgery (in cases with significant displacement), rehabilitation and long-term follow-up. 85 percents of growth plate fractures heal without sequelaes. The most frequent complications of a growth plate fractures are premature arrest, excessive growth and deformed limb. Researches continue to explore better and more efficient ways to diagnose and treat growth plate injuries and to improve patients' outcomes.
Summary		Poškodbe, še posebej pri mlajših osebah, so najpogostejši vzrok smrti in invalidnosti. Pri otrocih so zlomi specifični zaradi posebnosti otroškega skeleta, rastnih plošč in prožnosti otroških kosti. Kosti same lahko prenesejo celo določene večje sile kot pri odraslih, medtem ko so rastne plošče dva do trikrat bolj občutljive za poškodbe, a imajo tudi svoje prednosti: rastoča kost, ki se je deformirala, se lahko sčasoma sama izravna. Rastne plošče so iz rastnega hrustanca, ki omogoča rast kosti in ga, ko se rast zaključi (v starosti 16-20 let), nadomesti kost. Tipični zlomi, ki jih pri odraslih ne vidimo so: zlom zelene veje, zlom v obliki buckine glave in zlom rastne plošče. Zlome rastne plošče razdelimo po Salter-Harris-u v pet tipov, kjer je tip 1 najlažja oblika zloma, tip 5 pa najhujša. Zdravljenje je odvisno od tipa zloma, pomembni so čimprejšnji pričetek zdravljenja, analgezija, imobilizacija, ob (prekomernih) premikih naravnava oz. operativni poseg, rehabilitacija in spremljanje nadaljnje rasti. Približno 85 % zlomov se zaceli brez kasnih posledic. Možne posledice so: prezgodnji zastoj v rasti kosti, prekomerna rast kosti in upogib kosti in s tem deformiran ud. Kljub znanemu še vedno iščemo boljše in učinkovitejše poti v diagnostiki in pri zdravljenju poškodb rastne plošče, v želji za še boljši izid zdravljenja.
Descriptors		GROWTH PLATE FRACTURE HEALING EPIPHYSES CHILD