In spite of the many existing methods of treatment of elbow fractures, proportion of complications and poor outcomes is still quite a high. Difficulties in of the treatment of elbow fractures in children caused by a number of features: a complex anatomic and topographic location, small size of the distal fracture fragment, the frequency of damage to the articular capsule, blood vessels and nerves. This review describes the modern methods of treatment of children with this pathology.
Key words: Children, head of radius, result.
Introduction. Diagnosing fracture of head of radius, treatment and recovering the movement of elbow in a very short time is still a global problem [1,2]. In spite of having many methods of treatment these wounds and recovering the movement of elbow after hurting, achieving to a good result is still a dilemma of children’s traumatic surgeons [3,4,5].
Purpose. Treatment the fracture of head of radius and evaluating positive results in recoveringjoint’s movement.
Materials and results. Medical history of 147 children aged 4–15, who have been diagnosed wound of proximal part of radial bone and cured between 1994- 2013 years, analyzed in traumatology and orthopedics department at Tashkent Pediatric Medical Institute. Methods of surveys: clinic, x-ray, neurologic, US and Doppler graphic Fracture of radial bone has been analyzed in 12 patients and epiphysisal separation of radial bones, osteoepiphysisal separation of radial bones and fracture of neck of radius has been analyzed in the rest 135 patients. Displacement of bones’ part in fracture of radial bone has not been analyzed in 11 patients out of 12. As well as having positive results, treatment using the plaster — traditional method of treatment fracture of radial bone, is preventing an early movement of radial bones. As a result, rotational movements of radial bones are not recovering fully and children are becoming invalid.
Considering these, we have applied usage of functional splint in treatment the fracture of radial bones and recovering the joint’s movement in our traumatology department since 1994 and used in the processes of treatment 76 patients who has been diagnosed wound of proximal part of radial bone and 12 patients who have been diagnosed fracture of head of radius.
Functional splint of recovering movement of ulna (Patent to discovery: № FAP 00715, 29.03.2012)
Functional splint consists of two parts: first part is for shoulder and the other part is for forearm. They joint with plastic hinge and move. Expander is attached to the hand and it helps to improve blood circulation. Splint is made of leather and it covers hand shape easily. There are holes in the front part to bond the fibers. At the same time holes help to fixate the fibers and to refresh the air. Fibers are strengthened based on the beginning of the swollen after wounds and prevents the secondary displacement of the bones. Splint helps to do supination-pronation and extension-flexion movements.
The importance of treatment using the plastic splint: patients whose bones have not been displaced, they can be anaesthetized with 1 % Novocaine solution based on their ages and immobilization takes place after functional splint are set medium position during 2 weeks. In the beginning passive movements such as extension-flexion movements of radial, later on active movements such as rotational functions of radial are done after losing the pains and swollens of 6–8 days wound. If displacement of radial bones is analyzed, reposition is done after general anaesthetization. From the base of fingers till the top of the shoulder plaster is set in a medium position. After 5–7 days of wound, plaster is replaced with the functional splint and passive movements can be started.
Functional splint is removed after 2 weeks of wound. At this time first step of recovering the functions of elbow part is done which means during the process of treatment the fracture of radial bone movements of elbow part are recovered. After taking functional splint off, the second step of recovering the functions of elbow part is started which means physiotherapy treatments are ordered. These methods of cure are done in the outpatient setting.
Conclusion.Positive results of usage of the functional splint in treatment the fracture of radial bones and recovering the movement of elbow in a short time is approved. Ambulatory helps to reduce the stationary treatment and it prevents the consequences of wounds: supination-pronation and extension-flexion movements of elbow as well as becoming invalid forever.
References:
- O. Soloviev, O. V. Shekin, A. O. Shekin / / Errors and complications of treatment of closed elbow joint injuries in children / /. Pediatric Surgery, № 4, 2001, p. 14–18.
- Bielecki M. A., Krivitsun, A. V. Borisov O., Odintsov O. A., Gerasimenko M.A, Alekseichik S.S, Long SN. A method for treating fractures and osteoepifizeoliz of radial head in children with the use of the IC. / / Current issues of pediatric traumatology and orthopedics. St. Petersburg — 2005, pp. 21.
- Merkulov V.N, VT Stujina, Dorokhin A. I., Trotsenko V.V, Sokolov O.G, Yeltsin A. G. / / Errors and complications of osteosynthesis of fractures in children / /. Topical issues of child trauma and orthopedics, St. Petersburg, 2005, p. 36.
- S. Y. Fedjunina, G. I. Zhabin, A. V. Ambrosinkov, A. V. Bogdanov / / Treatment of fresh and chronic injuries of the radial head / /. Traumatology and orthopedics Russia, № 2, 2006, p. 290.
- Metaizeau J. P. //Reduction and osteosynthesis of radial neck fractures in children by centromedullary pinning//. Injury. 2005, Feb; 36 Suppl 1: A 75–76.
