Osteosynthesis of fractures on the short bones at the child

Abstract

Introduction: In this work, we included children with short bone fractures and some tubular bones smaller than the long bones. Treatment of children with these fractures is predominantly conservative, but there are cases that require surgical treatment with osteosynthesis. Material and methods: During the years 2011-2015 in the Clinic of Pediatric Orthopaedics and Traumatology, of the USMF,, Nicolae Testemițanu’’ of the National Scientific and Practical Center of Pediatric Surgery ”Natalia Gheorghiu”, orthopedic and surgical were treated 239 children with short bone fracture, children were divided by age 3-10 years – 57 children and 10 to 18 years – 182 children, by gender: girls 95, boys 139, with male prevalence being net. Distribution according to bone injured was: clavicle fractures – 125 children; II-V metacarpal fractures – 86 children; carpal scaphoid fracture 3 children; fractures of metatarsals II-IV – 25 children. Results and discussions: In the case of fracture of the clavicle, metacarpals II-V, carpal scaphoid, metatarsals II-IV, children shows pain at the site of trauma in all cases of fracture, local swelling, sometimes subcutaneous crackles perception associated with abnormal mobility. In all cases of fracture of the short bones correct diagnosis was confirmed radiographically. Orthopedic treatment benefited 61 children, but 178 children followed surgical treatment. All these cases of short bones fractures surgical treatment was performed: open reposition, adaptation of the fragment and fine osteosynthesis with Kirschner or Ilizarov cross brooches, they were followed in dynamics for at least 2-3 months after the removing of osteosynthesis material and cast immobilization, which was obtained a good result with restoration of the affected bone congruence in all children, data of signs of nonunion or other complications had not been recorded. Conclusion: 1. Fractures of clavicle, metacarpals bones II-V, scaphoid bone, astragals bone, metatarsals bones, injury occurring as a result of the increased activity of the child, caused by street accidents, sports competitions, physical aggression. 2. The surgical treatment - of listed fractures is indicated in unstable fractures with displacement, open fractures, polytrauma and consists of open reposition, adaptation of fragments - fine fixation with Kirschner brooches, followed by immobilization in a cast.