Osthesynthesis of lesions in tubular bones growth zones at children

Abstract

Introduction: Growth zone lesion areas of tubular bones at children are fairly common, their consequences are blocking of bone growing area and limb deformation. According to contemporary data - growth areas lesions represent 5% -17% of the total number of children fractures. The appearance of late growth, limb deformation are the signals of lesion in the growing area. Discussions: The purpose of this paper is to improve treatment results of children with affected growth areas, based on complex examination, using contemporary methods. Clinical data is based on analysis of treatment results of these injuries in our section. Over the last three years in our section were treated 239 children with lesion in growth area, which constitutes 11% of the total number of children with fractures. Of which 190 were during acute trauma and 49 with secondary damage. 91% were children with grade II after Solter Harris and more rarely - 9% grade I after Solter-Harris. Main method used in lesion diagnosis is the clinical radiological method. Computed tomography is indicated only for diagnosis concretization and the affected area appreciation. 190 cases were undergoing the treatment in the acute period, the orthopedic reduction was performed, by discharging of he affected area by skeletal traction and plaster immobilization. Indications for surgical treatment were the outdated lesions, inefficiency of orthopedic reduction. Surgical treatment methods - transosseous osteosynthesis, orthopedic and surgical reduction with pins fixation. The consequences treatment was surgical, using osteotomy methods for deformity correction, affected limb lengthening by the Ilizarov method. Treatment results assesment was based on the following indices: anatomical condition, functional during the trauma, deformities and limb shortness were appreciated during later period. Treatment results have been good and satisfactory 95.6% (228 cases). In 4.4% (11 cases) the results were unsatisfactory and required repeated surgical corrections. Conclusions: 1. The maintenance method is the stated method for children with growth zone lesions in the acute period. 2. The surgical treatment has indications in outdated lesions during late addressing. 3. Lesions in growing area at children represent 11% of the total number of tubular bone fractures, serious lesions causing limb deformity.