ZEMAN, J., Ondřej MAREK, Jakub TUREK, Anna SEEHOFNEROVÁ and Ladislav PLÁNKA. Porovnání dvou metod miniinvazivní osteosyntézy u zlomeniny proximálního konce vřetenní kosti v dětském věku (Comparison of Two Methods of Minimally Invasive Osteosynthesis for Proximal Radius Fractures in Paediatric Patients). Acta chirurgiae orthopaedicae et traumatologiae čechoslovaca. Praha: Galén, 2018, vol. 85, No 4, p. 276-280. ISSN 0001-5415.
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Basic information
Original name Porovnání dvou metod miniinvazivní osteosyntézy u zlomeniny proximálního konce vřetenní kosti v dětském věku
Name (in English) Comparison of Two Methods of Minimally Invasive Osteosynthesis for Proximal Radius Fractures in Paediatric Patients
Authors ZEMAN, J. (203 Czech Republic, guarantor), Ondřej MAREK (203 Czech Republic, belonging to the institution), Jakub TUREK (703 Slovakia, belonging to the institution), Anna SEEHOFNEROVÁ (203 Czech Republic, belonging to the institution) and Ladislav PLÁNKA (203 Czech Republic, belonging to the institution).
Edition Acta chirurgiae orthopaedicae et traumatologiae čechoslovaca, Praha, Galén, 2018, 0001-5415.
Other information
Original language Czech
Type of outcome Article in a journal
Field of Study 30211 Orthopaedics
Country of publisher Czech Republic
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 0.456
RIV identification code RIV/00216224:14110/18:00106381
Organization unit Faculty of Medicine
UT WoS 000442716100007
Keywords in English children; fracture; radius; proximal; osteosynthesis
Tags 14110312, 14110313, rivok
Tags International impact, Reviewed
Changed by Changed by: Soňa Böhmová, učo 232884. Changed: 27/2/2019 16:54.
Abstract
Poranění proximálního konce vřetenní kosti u dětí je závažný stav a dle literatury tvoří 5–19 % všech poranění v oblasti lokte a asi 1 % všech zlomenin u dětí (10). V souboru autorů za poslední 2 roky 1,8 %. V době manifestace sekundárního osifikačního jádra, která probíhá mezi 5.–7. rokem věku, má hlavička téměř stejný tvar jako u dospělých. Ke splynutí hlavičky s metafýzou dochází mezi 12.–15. rokem věku dítěte (5, 11). Nejčastěji dochází k danému poranění mezi 9.–10. rokem věku, u dívek se setkáváme s poraněním o 2 roky dříve než u chlapců (8). Dle literatury se fyziologické anatomické postavení proximálního radia mírně liší. Hlavice je na rentgenovém snímku v předozadní projekci angulována o 12,5–15° laterálně a o 3,5–5° ventrálně v boční projekci (3, 16). Toto postavení musí být během dia - gnostiky a léčby zlomenin respektováno (10). Rozhodující úlohu v diagnostice má rtg vyšetření.
Abstract (in English)
PURPOSE OF THE STUDY The presented study was construed as a retrospective multicentric clinical study focused on paediatric skeletal injuries of the proximal radius. As a general rule, the Type I displaced fractures (Judet classification) are treated conservatively, with no reduction. In the case of Type II-IV displacement, the fracture necessitates reduction or is also transfixed by a Kirschner wire (K-wire) or a Prevot nail (P-nail) where subsequent fragment instability occurs. The comparison aimed to ascertain whether there is a statistically significant difference between the two methods. No difference was expected by the authors, therefore a null hypothesis was set. MATERIAL AND METHODS The patients were treated at the Clinic of Paediatric Surgery, Orthopaedics and Traumatology (CPSOT) of the Faculty of Medicine of the Masaryk University and at the Clinic of Orthopaedics and Traumatology of the Musculoskeletal System of the University Hospital in Pilsen in the period from 2006 to 2015. Two methods of closed reduction and minimally- invasive osteosynthesis were evaluated. The first method was the elastic stable intramedullary nailing (ESIN) with a P-nail, the second method was an osteosynthesis using a K-wire. In the clinical part of the study, comparisons were made based on the monitoring of the same parameters - final restriction of movement, time to full weight bearing of the extremity and incidence of serious complications. RESULTS The final group comprised a total of 31 patients, of whom 7 boys and 24 girls aged 3-16 years with the median of 9-10 years. Some restriction of movement following the treatment occurred in a total of seven patients (44%) with the K-wire and in four patients (27%) with the P-nail. When comparing the movement at 5% level of significance using the Chi-Square tests, no significant difference was found (p = 0.446). When evaluating the serious complications at 5% level of significance using the Chi-Square tests, the difference between the two methods of treatment was again insignificant (p = 0.365). When the full weight bearing was compared (median K-wire 8 weeks, median P-nail 10 weeks), a statistically significant difference was obtained at 5% level of significance using the Fischer exact test (p = 0.003).
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