Author/Editor     Vindišar, Franci
Title     Operativno zdravljenje zlomov diafiz dolgih cevastih kosti pri otrocih in adolescentih v SB Celje od 1996 do 2007
Translated title     Operative treatment of long bones shaft fractures at children and adolescent in General hospital Celje during 1996 and 2007
Type     članek
Source     In: Komadina R, Smrkolj V, Pavlovčič V, et al. Zbornik izbranih predavanj Simpozija o poškodbah otroškega skeleta in poškodbah nevrokraniuma in možganov. Celje: Splošna bolnišnica,
Publication year     2009
Volume     str. 53-9
Language     slo
Abstract     Background. Operative treatment of fractured long bones in shaft region at children and adolescent needs exact knowledge of children skeleton and different operative methods. We should try to perform definitive treatment in one steep and in one anesthesia. Methods and results. During the period from 1996 to 2007 they treat with operation 72 children with femoral shaft fracture, 56 with tibia shaft fracture, 15 with humeral shaft fracture and 96 children with ulna and radius shaft fracture. In all groups boys were dominant. In femoral group they have 5 open fractures, in tibia group 17, in humeral group 2 and in ulna and radius shaft group 15. At femoral shaft fracture they perform elastic intramedular nailing in most cases, in tibia and humeral group open reduction and internal fixation (ORIF) was dominant and in group of ulna and radius shaft fracture again elastic intramedular nailing was dominant. Of complications surface inflammation of the skin at the place of application nails was dominant. In one case in femoral group they perform all three operative methods because of non union. In humeral group in one case ORIF was perform after primary use of external fixator. In ulna and radius group, they have great experiences with elastic intramedullary nailing. In groups of lover[!] extremity they notice small differences in the lenght, in most of treated children they registred good range of motion in surrounds joints. Conclusion. For operative treatment of shaft fractures of long bones exact knowledge of children skeleton is need and according to this and to the type of fracture right operative technique should be done, with as little as possible of additional injury.
Summary     Operativno zdravljenje zlomov diafiz dolgih cevastih kosti pri otrocih in adolescentih zahteva poznavanje značilnosti otroškega skeleta in poznavanje različnih možnosti operativnih tehnik. Slediti moramo osnovni ideji, da je zagotoviti dokončno terapijo v eni anesteziji in z enim operativnim posegom. Metode in rezultati. V obdobju od 1996 do 2007 so operativno zdravili 72 otrok z zlomom diafize stegnenice, 56 otrok z zlomom diafize golenice, 15 otrok z zlomom diafize nadlahtnice in 96 z zlomom diafize podlahtnice in koželjnice. V vseh skupinah so prevladovali dečki. Pri stegnenicah je bilo 5 zlomov odprtega tipa, pri goleni 17, pri nadlahti 2 in pri podlahti 15. Pri zlomih stegnenice je bila najpogosteje uporabljena elastična intramedularna fiksacija, pri golenih in nadlahteh odprta repozicija in notranja osteosinteza in pri podlahteh elastična intramedularna fiksacija. Od zapletov prevladujejo v vseh skupinah površinska vnetja na mestih apliciranih žic, v skupini stegnenic je opisan primer uporabe kar treh operativnih tehnik zaradi nazaraščanja zloma, pri nadlahteh pa primer reosteosinteze po refrakturi po primarni uporabi zunanjega fiksatorja. V skupini zlomov diafiz podlahti pa imajo največ izkušenj z uporabo elastične intramedularne fiksacije. Ob spremljanju rezultatov so v povprečju pri spodnjih okončinah ugotovili manjše razlike v dolžini okončin, v veliki večini primerov vseh skupin pa dobro gibljivost sosednjih sklepov zlomljenih diafiz dolgih kosti. Zaključek. Pri operativnem zdravljenju diafiz dolgih cevastih kosti je potrebno poznati značilnosti otroškega skeleta in glede na le-te in tip zloma uporabiti operativno tehniko,ki povzroča najmanjšo možno dodatno poškodbo in zagotavlja hitro celjenje zloma.
Descriptors     FEMORAL FRACTURES
HUMERAL FRACTURES
TIBIAL FRACTURES
ULNA FRACTURES
CHILD