{"title":"Republican Specialized Scientific and Practical Medical Center of Traumatology and Orthopedics, Tashkent, Republic of Uzbekistan","authors":"I. Khodzhanov, D. Borzunov, G.Dz. Bayimbetov","doi":"10.18019/1028-4427-2023-29-1-12-19","DOIUrl":null,"url":null,"abstract":"Introduction Diagnosis and treatment of children with multiple injuries of the bones that form the elbow joint is a relevant problem in pediatric traumatology. Due to the high variability of the cases encountered, it is necessary to differentiate the volume, timing and sequence of surgical interventions, as well as the duration of fixation of the injured limb with immobilizing means. The aim of the work was to study the dependence of long-term anatomical and functional treatment results in children with multiple fractures around the elbow joint on the type of injury. Materials and methods The medical records of 82 pediatric patients with multiple injuries of the bones forming the elbow joint were studied. The patients involed in the study were divided into two groups. Group 1 were patients with multiple fractures of the bones that make up the elbow joint (35 children), and group 2 were patients with intra-articular fractures of the distal end of the humerus and fracture-dislocations of the forearm bones in the elbow joint (47 children). The results were evaluated using the DASH questionnaire and the Broberg-Morrey rating scale. Results In the first group of patients with multiple fractures of the bones that make up the elbow joint, the anatomical and functional results of treatment were significantly better, and the process of restoring the function of the elbow joint was shorter. The treatment results of patients in the second group largely depended on the severity of the injuries. The use of the Ilizarov method with rational arrangements of the apparatus enables to preserve the function of the elbow joint in the course of transosseous osteosynthesis. In hybrid fixation (the use of pins and apparatus or plaster immobilization and apparatus), patients frequently developed immobilization contracture of the elbow joint and the anatomical and functional results turned out to be worse, since the fixed elbow joint needed long-term rehabilitation. Discussion Multiple injuries of the bones of the elbow joint are highly variable. The treatment of patients with multiple injuries of the elbow joint remains a difficult clinical task, partly because there is no differentiated approach to rehabilitation measures depending on the nature of the injury, and, accordingly, a rational approach to the treatment of this group of patients has not been developed. Due to the fact that most dislocations are usually associated with fractures, accurate diagnosis of the severity of injuries and rational surgical intervention in terms of timing and volume are necessary to achieve good anatomical and functional results. Conclusion Accurate and timely diagnosis of skeletal injuries of the elbow joint and rational determination of treatment tactics are of great importance in pediatric emergency traumatology. They determine the anatomical and functional outcomes of rehabilitation.","PeriodicalId":37426,"journal":{"name":"Genij Ortopedii","volume":"31 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Genij Ortopedii","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18019/1028-4427-2023-29-1-12-19","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction Diagnosis and treatment of children with multiple injuries of the bones that form the elbow joint is a relevant problem in pediatric traumatology. Due to the high variability of the cases encountered, it is necessary to differentiate the volume, timing and sequence of surgical interventions, as well as the duration of fixation of the injured limb with immobilizing means. The aim of the work was to study the dependence of long-term anatomical and functional treatment results in children with multiple fractures around the elbow joint on the type of injury. Materials and methods The medical records of 82 pediatric patients with multiple injuries of the bones forming the elbow joint were studied. The patients involed in the study were divided into two groups. Group 1 were patients with multiple fractures of the bones that make up the elbow joint (35 children), and group 2 were patients with intra-articular fractures of the distal end of the humerus and fracture-dislocations of the forearm bones in the elbow joint (47 children). The results were evaluated using the DASH questionnaire and the Broberg-Morrey rating scale. Results In the first group of patients with multiple fractures of the bones that make up the elbow joint, the anatomical and functional results of treatment were significantly better, and the process of restoring the function of the elbow joint was shorter. The treatment results of patients in the second group largely depended on the severity of the injuries. The use of the Ilizarov method with rational arrangements of the apparatus enables to preserve the function of the elbow joint in the course of transosseous osteosynthesis. In hybrid fixation (the use of pins and apparatus or plaster immobilization and apparatus), patients frequently developed immobilization contracture of the elbow joint and the anatomical and functional results turned out to be worse, since the fixed elbow joint needed long-term rehabilitation. Discussion Multiple injuries of the bones of the elbow joint are highly variable. The treatment of patients with multiple injuries of the elbow joint remains a difficult clinical task, partly because there is no differentiated approach to rehabilitation measures depending on the nature of the injury, and, accordingly, a rational approach to the treatment of this group of patients has not been developed. Due to the fact that most dislocations are usually associated with fractures, accurate diagnosis of the severity of injuries and rational surgical intervention in terms of timing and volume are necessary to achieve good anatomical and functional results. Conclusion Accurate and timely diagnosis of skeletal injuries of the elbow joint and rational determination of treatment tactics are of great importance in pediatric emergency traumatology. They determine the anatomical and functional outcomes of rehabilitation.
期刊介绍:
Journal’s main goal is to contribute to the development of the contemporary medical science via presentation of fundamental and applied original scientific studies to the scientific and practical medical community that would widen and deepen the understanding of the most important problems in the field of traumatology, orthopaedics, and related specialties. Our journal provides a direct open access to its content which is based on the principle that the open access option promotes global exchange of knowledge and experience. Journal’s strategy: -Development of the journal as a scientific platform for researchers, doctors, post-graduates and residents -Attraction of highly-cited authors to publish their studies -Selection of manuscripts of scientific interest for readers that will impact on journal citation index in RINC -Increase in the portion of publications submitted by foreign authors and studies conducted in association with foreign scientists; growth of citations in the journals that are included into global systems of indexing and reputable databases -Improvement of the Journal’s web site in two languages for a greater accessibility by authors and readers -Introduction of the Journal into global indexing systems