Author/Editor		Brilej, Drago; Robida, Jože; Kocuvan, Samo; Komadina, Radko
Title		Poškodbe otroškega skeleta - meje konservativnega zdravljenja
Translated title		Fractures in children - limitations of conservative treatment
Type		članek
Source		In: Zbornik predavanj XLVI. podiplomskega tečaja kirurgije za zdravnike, 25. in 26. november 2016 Ljubljana : Slovensko zdravniško društvo
Publication year		2016
Volume		str. 85-91
Language		slv
Abstract		Zlomi pri otrocih so pogosti in pomembno vplivajo na njihove aktivnosti. Anatomija in biomehanika otroške kosti sta drugačni kot pri odraslih. Celjenje poteka hitreje, sposobni so korekcije deformacij po zlomu. Večino zlomov lahko pozdravimo brez operacije. Toda funkcionalni rezultati zdravljenja niso vedno najboljši. Ob razvoju boljših operativnih materialov in tehnik se kar ponujajo možnosti operativnega zdravljenja zlomov tudi pri otrocih. Zlome tipa Salter Harris 3 in 4 težko zdravimo brez operacije, prav tako nestabilne metafizarne zlome. Tudi zdravljenje zlomov stegnenice je pri večini otrok domena operativnega zdravljenja. Operativno zdravljenje je povezano s specifičnimi zapleti pri do 25 % operiranih otrok. Glede na tradicionalno dobre rezultate konzervativnega zdravljenja je pri otroku smiselno najprej pomisliti na konzervativno zdtavljenje zlomov, razen če so prisotne indikacije za operacijo.Fractures in otherwise healthy children are important because they are common, impact on daily activity, and may identify those who may have and increased fracture risk as adults. The anatomy and biomechanics of paediatric bone differ from that of adult bone, leading to unique paediatric fracture patterns, healing mechanisms, and management. The nature of most fractures in children makes them suitable for closed management. However, functional outcomes are not uniformly good and there is evidence that poorer outcomes may be underreported in children. The role for internal fixation is becoming better-defined. Most Salter Harris type I and II fractures are treated by closed methods while Salter Harris type III and IV fractures almost always require internal fixation. Metaphyseal fractures can be managed as Salter Harris II fractures, but are more likely to require some form of internal fixation. The management of long bone diaphyseal fractures is more controversial. Internal fixation of fractures in children is associated with complications in up to 25% of cases. The risk of complications should be considered before proceeding with surgery. Closed treatment should be attempted in children unless there is a good indication for internal fixation.
Descriptors		Fractures, bone Fracture healing Child Zlomi kosti Celjenje zlomov Otrok