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Treatment of simple separation of distal radial epiphysis in children


Authors: Karel Čermák;  Petr Havránek;  Tomáš Pešl
Authors place of work: Department of Paediatric and Trauma Surgery, Charles University of Prague, 3rd Medical School, Thomayer University Hospital, Regional Paediatric Trauma Centre ;  Klinika dětské chirurgie a traumatologie 3. LF UK a FTNsP, Praha, Centrum dětské traumatologie
Published in the journal: Úraz chir. 18., 2010, č.3

Summary

Introduction:
Fracture of the distal forearm is one of the most common skeletal injuries in children. The therapeutic approach varies from a non-operative to surgical treatment.

Objective:
Retrospective study of therapeutic methods in simple displaced separation of distal radial epiphysis treated in our department was performed.

Material and Methods:
during the period of 5 years (2004–2008) 509 patients were treated at our out-patient department with separation of the distal radial epiphysis. We evaluated methods of treatment according to the direction and grade of displacement, and stability after closed reduction.

Results:
In the cohort of 509 patients we noted 352 non-displaced and 157 displaced separations of distal radial epiphysis. Only 19 patients were indicated to surgical procedure. In the case of dorsal displacement in 124 patients (94 %) the non-operative treatment with closed reduction and plaster cast was used, no patient was operated on primarily and 8 patients (6 %) were operated on for secondary re-displacement. In case of volar displacement 14 children (70 %) were treated with closed reduction and plaster cast, 1 patient (5 %) was operated on primarily and 5 patients (25 %) were operated on for secondary re-displacement.

Conclusions:
The dorsal displacement of separation of the distal radial epiphysis is more frequent than the volar one. However, the volar displacement is less stable and therefore more frequently indicated for surgical procedure.

Key words:
distal radius, children, physis, Salter-Harris schedule.


Zdroje

1. Bartoníček, J., Džupa, V., Frič, V. et al. Epidemiologie a ekonomie zlomenin proximálního femuru, proximálního humeru, distálního radia a luxačních zlomenin hlezna. Rozhl Chir. 2008, 87, 213–219. ISSN 0035-9351.

2. Binfield, P. M., Sott-Miknas, A., Good, C. J. Median Nerve Compression Associated with Displaced Salter-Harris Type II Distal Radial Epiphyseal Fracture. Injury. 1998, 29, 93–94. ISSN 0020-1383.

3. Bumei, G., Gavriliu S., Georgescu, I. et al. The Therapeutic Attitude in Distal Radial Salter and Harris Type I and II Fractures in Children. J Med Life. 2010, 3, 70–75. ISSN 1844-122X.

4. Friberg, K. S. I. Remodelling after Distal Forearm Fractures in Children. Acta Orthop Scand. 1979, 50, 537–546, 731–739. ISSN 0001-6470.

5. Ghoneem, H. Pediatric Displaced Distal Forarm Fractures: Avoiding Failure of Treatment. J Bone Joint Surg Br. 2003, 85B, 262–263. ISSN 0301-620X.

6. Havránek, P. Dětské zlomeniny. 1. vyd. Praha: Corvus, 1991. 204 s. ISBN 80-900014-2-4.

7. Havránek, P., Pešl, T. Následky poranění růstové chrupavky dětské kosti a možnosti jejich léčebného ovlivnění [závěrečná zpráva grantu IGA MZ ČR NR/9132-3/2007]. 2010. 37–39.

8. Justan, I., Poul, J., Gál, P., Bíbrová, Š. Možnosti korekce posttraumatických délkových diskrepancí předloketních kostí u dětí (kazuistika). Acta Chir Orthop Traumatol Cech. 2004, 71, 373–378. ISSN 0001-5415.

9. Laurer, H., Sander, A., Wutzler, S. et al. Therapieprinzipien distaler Unterarmfrakturen im Kindesalter. Chirurg. 2009, 80, 1042–1052. ISSN 0009-4722.

10. Lee, B. S., Esterhai, J. L. jr., Das, M. Fracture of Distal Radial Epiphysis: Characteristics and Surgical Treatment of Premature, Post-traumatic Epiphyseal Closure. Clin Orthop Relat Res. 1984, 185, 90–96. ISSN 0009-921X.

11. Mostafa, M. F., El-Adl, G., Enan A. Percutaneous Kirschner-wire Fixation for Displaced Distal Forearm Fractures in Children. Acta Orthop Belg. 2009, 75, 459–466. ISSN 0001-6462.

12. Peterson, H. A. Epiphyseal Growth Plate Fractures. 1st ed. Berlin: Springer, 2007. 914 s. ISBN 978-3-540-33801-7.

13. Price, C. T. Surgical Management of Forearm and Distal Radius Fractures in Children and Adolescents. Instr Course Lect. 2008, 57, 509–514. ISSN 0065-6895.

14. Stühmer, K. G. Distale Vorderarmfrakturen. In Weber, B. G., Brunner, C., Freuler F. Die Frakturenbehandlung bei Kindern und Jugendlichen. 1. Aufl. Berlin: Springer, 1978. 414 s. ISBN 3-540-08299-9.

Štítky
Surgery Traumatology Trauma surgery
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