Fracture of the humerus in children

Zbog hiperaktivnosti djeca su često izložena ozljedama nadlaktice, a prijelomi nadlaktične kosti i nakon operativnog liječenja mogu ostaviti trajne posljedice. Pretežiti mehanizam nastanka ove ozljede je pad u razini tla. Visoka pojavnost prijeloma, opravdava propitivanje o mogućoj prevenciji nastanka. Preventivna postupanja moguća su jedino uz poznavanje uzroka i okolnosti nastanka prijeloma. Cilj ovog rada je analizirati okolnosti nastanka, i kritična mjesta i aktivnosti djece kod nastanaka prijeloma nadlaktične kosti po dobnim skupinama. U radu je analizirano 102 djece liječenih u KBC-u Zagreb zbog prijeloma nadlaktične kosti, u periodu 2010.-2014. U studiji je analizirano 45 djevojčica (44 %) i 57 dječaka (56%). Prosječna starost djece iznosila je 8,3 godina. Prijelomi distalne trećine nadlaktične kosti čine 4/5 svih analiziranih prijeloma. Nešto češće je bila zahvaćena lijeva ruka. Gotovo 80% prijeloma je bilo nestabilno. Radilo se uglavnom o nestabilnim prijelomima koji su u pravilu zahtijevali operacijsko liječenje. Najviše ozlijeđenih je bilo u dobi od 5 do 9 godina. Najčešće su se ozljede događale na rekreacijskom mjestu (47 %), zatim kod kuće (31%), zatim na ulici ili cesti (15%) te u školi ili vrtiću (7%). Način nastanka ozljede uglavnom je pad na ruku (94 %), a ostatak ozljeda posljedica je izravnog udarca. Gotovo polovina djece se ozljedila u sportskim ili rekreacijskim aktivnostima. Daleko najčešće stradaju djeca u predškolskoj i ranoj školskoj dobi u igri i kontaktu sa drugom djecom slične dobi. Kako bi smanjili učestalost ovakvih ozljeda, preventivne aktivnosti treba usmjeriti ka najugroženijoj dobnoj skupini (5-9 godine) kod dnevnih aktivnosti pod nadzorom roditelja, ali i povećati nadzor u predškolskim i školskim ustanovama. Od svih aktivnosti najopasniji po nastanak prijeloma nadlaktične kosti su sportska igrališta i mjesta rekreativnih aktivnosti predškolske i djece u nižim razredima osnovne škole.Due to hyperactivity, children are often exposed to injuries of the upper arm and fractures of the humerus can leave permanent damage even after the surgical treatment. Same level falls are the predominant mechanism of this injury. The high incidence of fractures justifies questioning the possible prevention of this injury. Preventive actions are possible only with the knowledge of the causes and circumstances of the fracture. The aim of this paper is to analyze the circumstances of the injury, critical places and activities engaged in at the time of the humeral fracture by age groups. The paper analyzed 102 children that were treated at the University Hospital Centre in Zagreb due to fractures of the humerus in the period of 2010 to 2014. In this study, we analyzed 45 girls (44%) and 57 boys (56%). The average age of children was 8,3 years. Fractures of the distal third of the humerus accounted for 4/5 of all analyzed fractures. The left hand was affected more frequently. Nearly 80% of fractures were unstable. The patients mainly presented with unstable fractures that required surgical treatment. The injury occurred most often among the 5-9 year-olds. Most injuries took place at the recreational facilities (47%), followed by injuries at home (31%), on streets or roads (15%) and at school or kindergarten (7%). Mechanism of the injury was mainly a fall onto the arm (94%) and the rest of the injuries were due to a direct blow. Almost half of the children got injured in sports or recreational activities. Due to close physical contact and engagement in games, children in preschool and early school age are by far the most susceptible to injuries. To reduce the incidence of such injuries, preventive actions should be taken during daily activities under the supervision of parents towards the most vulnerable age group (5-9 years), along with increasing the supervision in preschools and schools. Of all the activities, the most dangerous to cause fractures of the humerus occur in sports grounds and recreational facilities of preschool children and children in the lower grades of elementary school