Title Prijelomi klavikule u djece
Title (english) Clavicular fractures in children
Author Nikša Matković
Mentor Anko Antabak (mentor)
Committee member Tomislav Luetić (predsjednik povjerenstva)
Committee member Tomislav Meštrović (član povjerenstva)
Committee member Anko Antabak (član povjerenstva)
Granter University of Zagreb School of Medicine (Department of Surgery) Zagreb
Defense date and country 2014-07-15, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Surgery
Abstract Klavikula je jedina duga cjevasta kost u tijelu položena horizontalno i predstavlja pričvrsnicu ramenog obruča za sternum. Kao takva, podložna je silama kompresije prenesenima s ruke i ramena i sili direktnog udarca, te je jedna od kostiju koje se u djece najčešće lome. Dijagnostički postupci koje koristimo su fizikalni pregled i rendgensko snimanje. Prijelom medijalne trećine je teško vidljiv na uobičajenom rendgenogramu, pa su potrebne posebne projekcije, ponekad čak i kompjuterizirana tomografija. Dječji organizam je osjetljiviji na zračenje od odraslog, te se količina zračenja mora svesti na potrebni minimum. Dječja klavikula, u usporedbi s odraslom, ima puno veću sposobnost cijeljenja, te se u većini slučajeva može liječiti konzervativno. Najčešći su prijelomi srednje trećine. Prijelomi lateralne i medijalne trećine su zapravo odvajanja kompakte od periosta, iz kojeg se može regenerirati cijela prelomljena trećina. Prijelomi se konzervativno liječe postavljanjem imobilizacije osmicom ili Desault-ovim zavojem. Uvijek se operativno liječe prijelomi s pridruženom ozljedom brahijalne arterije ili vene, brahijalnog pleksusa ili apeksa pleure, prijelomi s rotacijom ulomka za 90°, sa pseudodislokacijom akromioklavikularnog zgloba. Nakon otvorene repozicije, ulomci se fiksiraju Kirschnerovom žicom ili pločicom i vijcima. Iz baze podataka Kliničkog bolničkog centra Rebro napravljena je statistika prijeloma klavikule u 128-ero djece, s usredotočenošću na aktivnost koju su djeca obavljala tijekom zadobivanja prijeloma i mjestu na kojem se ta ozljeda dogodila. Djeca su najviše ozljeđivana kod kuće, zatim na ulici ili cesti, pa na rekreacijskom mjestu, a najmanje u školi ili vrtiću. Ambulantno je liječeno 106 (82.8%) djece i prosječno su rendgenski snimani 1,5 puta kroz period od prosječno 2,3 tjedna. Operativno liječeni pacijenti su pored intraoperativne dijaskopije prosječno snimani konvencionalnom radiografijom 3,2 puta.
Abstract (english) Clavicle is the only long hollow bone positioned horizontally and represents the attachment of the shoulder girdle to the sternum. As so, it is submissive to the compression forces transmitted from the hand and shoulder and to direct hit forces, and is one of the most frequent fractured bones in children. Diagnostic procedures used for those fractures are physical examination and x-ray. Medial third fracture is hardly visible on the usual x-ray, therefore additional projections are needed, sometimes even computed tomography. A child`s organism is more susceptible to radiation than the grown up`s, and the radiation quantity must be brought to a minimum. Children`s clavicle, compared to the adult`s, has a lot bigger healing potential, and can be treated conservatively in most cases. The most frequent are the mid-third fractures. Lateral and medial third fractures are actually separation of compact bone from the periost, from which the whole fractured third can be regenerated. Conservative treatment includes the figure of eight and Desault bandage. Operative treatment is preserved for the fractures with associated injury of brachial arthery or vein, brachial plexus or pleural apex, fragment rotation by 90°, with acromioclavicular pseudodislcation. Open reposition is fixated with Kirschner wire or a plate. Clavicle fractures statistics for 128 children are made from Klinički bolnički centar Rebro database, with focus on the activity children were practicing when the injury occured and on the site at which the injury happened. The most frequent site of injury was at home, then the road and street, then the recreational place, and the least at school or in kindergarten. Of all children 106 (82.8%) had ambulant treatment and were filmed by x-ray 1,5 times in average, during an average period of 2,3 weeks. The children who received operative treatment beside intraoperative diascopy were filmed by x-ray 3,2 times in average.
Keywords
prijelom
klavikula
dijete
uzrok
mjesto
Keywords (english)
fracture
clavicle
child
cause
location
Language croatian
URN:NBN urn:nbn:hr:105:339576
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2015-11-11 13:09:24