Liječenje prijeloma femura u djece

master's thesis

• Title (english): Treatment of femoral fractures in children
• Author: Nikolina Boršćak
• Mentor: Anko Antabak (mentor)
• Committee member: Krešimir Bulić (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Anko Antabak (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Prijelomi femura jedni su od najrjeđih prijeloma u dječjoj dobi. Femur je konstantno izložen djelovanju raznih vanjskih sila, no zbog svoje čvrstoće rijeko se lomi. Cilj ovog rada bio je prikazati načine liječenja prijeloma femura u djece, te kako određeni faktori utječu na odabir načina liječenja.
Radom je uključeno 106 djece u starosti do 18. godine života liječenih u Kliničkom bolničkom centru Zagreb i Klinici za dječje bolesti Zagreb radi prijeloma femura. Podaci su dobiveni retrospektivnim istraživanjem u razdoblju od 2008. do 2016. godine za KBC Zagreb i u razdoblju od 2014. do 2015. za Kliniku za dječje bolesti Zagreb. Uzrok ozljede i dijagnoza kodirani su pomoću međunarodne klasifikacije bolesti.
Operativno liječenje prijeloma femura u djece bilo je u 55 % slučajeva, što je u suprotnošću sa dosadašnjim istraživanjima. Najveća učestalost prijeloma je dobnoj skupini 0. do 4. godine (49 %). U njih prijelom u pravilu nastaje padom, a liječenje se češće provodi konzervativnim metodama. Sve druge skupine djece pretežito su liječene operativno. Od konzervativnih metoda najčešće je upotrebljavana sadrena imobilizacija, a od operativnih se daleko najviše koristila elastična stabilna intramedularna fiksacija. Odabir liječenja uvjetovali su dob djeteta, složenost prijeloma, tip prijeloma, pomak ulomaka i pridružene ozljede. Uzroci su također bili bitni za određivanje načina liječenja. Konzervativno liječenje češće je upotrebljavano za liječenje prijeloma nastalih padom(62 %), a operativno za prijelome nastale u prometnim nezgodama (79 %).

Abstract (english)

Femur fractures are one of the rarest fractures in children. The femur is constantly exposed to various external forces but it rarely fractures because of its structure. The aim of this research was to determine the methods of femoral fracturetreatment, but also how some factors such as age, cause of fracture, complexness etc. influence the choice of the treatment method.
The research included 106 children up to 18 years of age treated at the University Hospital Center of Medicine Zagreb and the Clinic for children diseases Zagreb for femur fractures. The data was obtained with a retrospective study in the period from 2008. to 2016. for the University Hospital Center of Medicine Zagreb, and the period from 2014. to 2015. for the Clinic for children diseases Zagreb. The cause of the fracture and the diagnosis were coded with the help of the MKB-10 classification.
It was shown that operative treatment is more common than conservative treatment with 55 % of cases treated with operative methods, as opposed to the findings of other researches on this matter, where conservative methods are leading. The age group with the highest incidence of femur fractures is the one aged from 0 to 4 years that accounts 49 % of all fractures. Those fractures mostly occur due to falls and are the only ones that are more commonly treated with conservative methods. All other age groups are mostly treated with operative methods. The only used conservative method was spica immobilization, and the most used operative method was flexible intramedullary nailing with TEN. The treatment depended on age, complexness of the fracture, was the fracture open or closed, displacement, completeness of the fracture and associated injuries. The cause was also an important factor for determining the treatment. Conservative treatment was mostly used for fractures caused by falls in 62 % cases of all falls, and operative treatment was mostly used for fractures caused by traffic accidents in 79 % cases of all traffic accidents.

• Keywords: prijelom femura; liječenje; djeca
• Keywords (english): femoral fractures; treatment; children
• Language: croatian
• URN:NBN: urn:nbn:hr:105:767993
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-07-12 11:05:57