Long-term results of treatment for refractures in children

Косимов А.А., Ходжанов И.Ю.

Abstract


Purpose. To optimize the techniques of treatment for refractures in children by combining different surgical approaches, and by possible prolongation of immobilization periods with studying long-term results.
Materials and Methods. The long-term results of treatment studied in 103 patients with refractures. The results (clinical, radiological, and functional) evaluated by three-point system: good – 3 points, satisfactory – 2 points, unsatisfactory – 1 point. Children were operated using the technique of combined osteosynthesis with achieving positive results in case of unsatisfactory results of refracture conservative treatment.
Results. Unsatisfactory results obtained in two patients out of six when using intramedullary osteosynthesis: pseudoarthrosis of radial lower third developed in one patient, and contracture of the elbow developed in another child due to prolonged immobilization. In contrast to intramedullary ostesynthesis, there were no refractures and other complications when combined osteosynthesis used due to additional external fixation, but in this case immobilization periods increased up to 2-3 weeks on the average.
Conclusion. When selecting a technique of treatmentfor refractures in children a conservative technique is preferred. When a surgical technique is required a combined one should be preferred which allows to consider itself the best surgical solution of the problem, and which completely eliminates the likelihood of developing refractures, nonunions and pseudoarthroses.

Keywords


children, long tubular bones, forearm, humerus, femur, refractures, intramedullary osteosynthesis, a pin, combined osteosynthesis, the Ilizarov fixator, plaster cast, immobilization periods

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