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Volume 15
Issue 1
Online publication date 2014-03-12
Title Clinical features the diaphyseal refractures of the forearm in children
Author A. Kosimov, Iskandar Khodjanov, G. Bayimbetov, Sherali Khakimov
Abstract
Background: The forearm refractures are the most common and serious injuries in the childhood. In our practice the refractures in children occur from 1.3% up to 5.2% among all fractures in children. Clinical characteristics of the refractures were highlighted insufficiently.

Purpose: To study clinical signs of forearm refractures and effect of osteoreparative process.

Material and methods: In the department of children's trauma of Scientific Research Institute of Traumatology and Orthopedics during the period from 2002 to 2012 from the general number of the patients 136 children with refracture of the tubular bones were revealed. With regard to the number of fractures twice refractures were in 132 patients, three times refractures found in 4 patients. From these patients 102 were boys and 34 were girls. According to structure of refracture localization the forearm refractures were on the leading place, which were observed in 109 (80.1%) of patients. The refractures of the middle third forearm were noted in 82 patients, the refracture of middle upper third forearm - in 2 patients, the refracture of the lower third forearm was in 25 patients. 

Results: In the refractures at the second stage of regeneration (time of occurrence more than 3 months), especially at the moment of active process of the callus ossification the close of medullar canal occur and hematoma volume became significantly less than in primary fracture. At refractures hematoma at the place of fracture was more localized. At the refracture the weak pain is defined, and sometimes pain can be absent (about the reasons is said above), and the main active and passive movements in the full volume. The cases of absence of crepitation are possible in refractures. It is important that in refractures the longitudinal and impacted displacement we did not observe. In cases with painless clinical course of the refracture in the patients the active and passive movements were saved in complete volume. We have noted above the presence of callus, insignificant volume of the hematoma or its fast resorption, weak pain syndrome can slow down processes of regeneration of bones in children.

The conclusions: Analyzing our observations we concluded that all clinical symptoms are important both in diagnostics and in a choice of strategy and tactics of the further treatment and achievement of complete consolidation of bones and complete restoration of the extremity function.




Citation
References
Baitner, A.C., Perry, A, Lalonde, F.D., Bastrom, T.P., Pawelek, J., Newton, P.O., 2007. "The healing forearm fracture: A matched comparison of forearm refractures," J. Pediatr Orthop., Vol.27(7), pp.743-747, http://dx.doi.org/10.1097/BPO.0b013e318142568c
 
Beaupre, G.S., Csongradi, J.J., 1996. "Refracture risk after plate removal in the forearm,"J Orthop Trauma, Vol.10(2), pp.87-92, http://dx.doi.org/10.1097/00005131-199602000-00003
 
Park, H.W., Yang, I.H., Joo, S.Y., Park, K.B., Kim, H.W., 2007. "Refractures of the upper extremity in children," Yonsei Med J., Vol.48(2), pp.255-260, http://dx.doi.org/10.3349/ymj.2007.48.2.255
 
Schwarz, N., Pienaar, S., Schwarz, A.F. et al., 1996. "Recurrent fracture of the pediatric forearm," J. Straub G.Unfallchirurg, Vol.99(3), pp.175-182
Keywords Forearm, refracture, clinical signs, children, osteoreparative process
DOI http://dx.doi.org/10.15208/mhsj.2014.03
Pages 20-26
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