Elastična stabilna osteosinteza prijeloma kostiju u djece

master's thesis

• Title (english): Elastic stabile nailing of fractures in children
• Author: Lucia Ivković
• Mentor: Anko Antabak (mentor)
• Committee member: Ivan Dobrić (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: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Elastična stabilna osteosinteza (eng. Elastic Stable Intramedullary Nailing, ESIN) standardna je metoda stabilizacije prijeloma dijafiza i metafiza kostiju u djece. Prednosti metode su zatvorena repozicija, minimalna dodatna oštećenja tkiva prilikom uvođenja čavala, odličn estetski ishod, brz postoperativni oporavak i jednostavno uklanjanje implantata. Čavli pružaju elastičnu aksijalnu stabilnost ali istovremeno dopuštaju mikropokrete koji pospješuju cijeljenje. Postupak uključuje, ovisno o mjestu prijeloma, anterogradno ili retrogradno uvođenje dvaju čavala u medularni kanal koji na principu uporišta u tri točke stabiliziraju prijelom. Komplikacije su najčešće posljedica odabira čavala malog promjera, asimetrije prilikom uvođenja čavala ili višestrukog presavijanja čavala unutar medularnog kanala što dovodi do neodgovarajuće stabilizacije prijeloma. Posebne indikacije uključuju patološke prijelome povezane s cerebralnom paralizom, osteogenesis imperfectom, juvenilnim koštanim cistama i neuromuskularnim bolestima. Donja dobna granica za primjenu ove metode je starost djeteta od tri do četiri godine, dok je gornja dobna granica petnaest godina. Metoda je kontraindicirana u pretile djece i kod intraartikularnih prijeloma.

Abstract (english)

Elastic stable intramedullary nailing (ESIN) has become a well-accepted method for stabilization of diaphyseal and metaphyseal fractures in children. The advantages include closed reduction, avoidance of injury of the surrounding tissue while introducing the nails, great aesthetic outcome, and early postoperative weight-bearing and easy removal of the implants. The nails provide adequate axial stability and optimal healing due to stimulated micro movements. The procedure involves, depending on the site of fracture, anterograde or retrograde nailing of the medullary canal with two nails, producing a three point support system. Complications are mainly caused by the wrong choice of the nail diameter, asymmetrical entry points of the nails and multiple twisting of the implants leading to inadequate stabilization of the fracture. Special indications include pathological fractures associates with cerebral palsy, osteogenesis imperfecta, juvenile bone cysts and neuromuscular diseases. The lower age limit is three to four years and the upper limit is fifteen years. The procedure is contraindicated in overweight patients and for intraarticular fractures.

• Keywords: djeca; prijelomi; elastična stabilna osteosinteza; komplikacije; posebne indikacije; kontraindikacije.
• Keywords (english): children; fractures; intramedular nailing; complications; special indications; contraindications.
• Language: croatian
• URN:NBN: urn:nbn:hr:105:148567
• 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: 2016-08-10 09:42:41