| Abstract | Prijelomi palčane kosti čine najveći dio prijeloma u dječjoj dobi. Prijelomi su u najvećem broju locirani u distalnoj trećini. Glavni mehanizam nastanka ozljede jest pad na ispruženu ruku. Za postavljanje dijagnoze najbitniji su anamneza, fizikalni pregled te rendgensko snimanje. Uglavnom se liječenje provodi imobilizacijom, a ako je potrebna repozicija zbog pomaka ulomaka provodi se zatvorena repozicija. Ostale metode liječenja koje se provode su otvorena repozicija i metode unutarnje fiksacije - postavljanje Kirschnerove žice ili ugradnja intramedularnog čavla.
Ova je retrospektivna studija uključila 201 dijete mlađe od 18 godina s prijelomom palčane kosti liječeno u KBC-u Rebro. Cilj je prvenstveno bio prikazati najčešće načine i mjesta ozljeđivanja palčane kosti u djece. U studiji je sudjelovalo 85 djevojčica (42,3%) i 116 dječaka (57,7%). Srednja vrijednost životne dobi djece iznosila je 9.6 godina. Palčana je kost ozlijeđena u distalnom segmentu u 159 (79,1%) djece. Mjesta gdje su djeca stradala su: park, kamp i plaža - 50 djece (24,9%), igralište, klizalište i bazeni – 48 (23,9%), škola, vrtić ili jaslice - 42 (20,9%), kod kuće i oko kuće – 36 (17,9%), na ulici – 23 (11,4%) te u trgovini ili hotelu - dvoje (1%). 43 dječaka (37,1%) ozlijeđena su na igralištima, klizanju i na bazenima, dok je 36 djevojčica (42,4%) ozlijeđeno u parkovima,kampovima i na plažama. U 99 slučajeva (49,3%) način nastanka ozljede je pad, koji je najčešće nastao klizanjem i rolanjem - 32 slučaja. U 83 djece uzrok ozljede su guranje i udarac. Najmanji broj djece, odnosno njih 19 (9,5%) ozlijeđeno je u prometu i to vozeći bicikl (jedno je dijete udario automobil). Sportske su aktivnosti uzrok nastanka ozljede u 108 slučajeva (53,7%). Najviše je djece primarno liječeno samo imobilizacijom - njih 140 (69,7%). Prosječno je svako dijete liječeno ambulantno bilo snimano 1,3 puta, a liječeno bolnički 3,2 puta, ne uključujući dijaskopiju u operativno liječene djece. Srednja vrijednost trajanja imobilizacije u ambulantno liječenih iznosilo je 2,3 tjedna, a u bolnički liječenih 4,1 tjedan.
Sportske su aktivnosti najvažniji uzrok nastanka ozljede palčane kosti u dječjoj populaciji, a padovi u toku sporta glavni su mehanizam nastanka ozljede. Dječaci najviše stradavaju u dobi od 12 godina, a djevojčice u dobi od 10 godina pa su to dobne skupine u kojima je potrebno najviše djelovati. Preventivno djelovanje potrebno je usmjeriti na ozljede nastale u parkovima te u školi i na sportskim treninzima. |
| Abstract (english) | Fractures of the radius account for the largest portion of fractures in childhood. Fractures are mostly located in the distal third of the bone. The main mechanism of injury is fall onto an outstretched hand. Case history, physical examination and radiographs are the most important diagnostic procedures. The main treatment method is immobilization, but if the reposition of the displaced fragment is necessary, closed reduction technique is performed. Other treatment options are open reduction and internal fixation methods - placing K-wires or intramedullary nail installation.
This retrospective study included 201 children under the age of 18, treated at Klinički bolnički centar Rebro. The primary aim was to examine the most common ways and the most common sites of the radius injuries in children. The study included 85 girls (42.3 %) and 116 boys (57.7 %) . The overall mean age of the children was 9.6 years. Radius bone was injured in the distal segment in 159 (79.1%) children. The sites of injuries were: the park, camping and the beach - 50 of all children (24.9 %), playground, skating rink and swimming pool - 48 (23.9 %) , kindergarten or school - 42 (20.9 %), at home and around the house - 36 (17.9 %), in the street – 23 (11.4 %) and in the store or at the hotel - two (1 %). 43 of the boys (37.1%) were injured at the playgrounds, during skating and at the swimming pools, while 36 girls (42.4 %) were injured in parks, camps and at the beaches. In 99 cases (49.3 %) fall was the cause of the injury, and children usually fell during ice skating and skating – 32 cases. In 83 children the cause of injury were pushing and hitting. The lowest number of children - 19 (9.5%) of them, were injured in traffic related accidents while riding a bike (only one child was hit by a car). Sport related activities caused injuries in 108 (53.7 %) cases. Most of the children were treated primarily only by immobilization – 140 of them (69.7 %). Outpatients were filmed by x-rays on average 1.3 times, and patients treated in hospital 3.2 times.The mean duration of immobilization in outpatients lasted for 2.3 weeks, and in children treated in hospital 4.1 weeks.
Sport activities are the most important cause of the radius fractures in the pediatric population and falling during sport is the main mechanism of injury. The peak incidence occured at 12 years for boys and at 10 years for girls, so these ages mark the critical point for intervention and/or prevention. Preventive actions should be focused on injuries that tend to occur in parks, schools and during sport activities. |
