Distal radial fractures in the pediatric population of the Zadar area

Prijelomi podlaktice najčešći su prijelomi dječje dobi. Najčešći uzrok prijeloma u ovoj dobi je pad na ispruženu ruku gdje dolazi do izbijanja osovine donjeg dijela podlaktičnih kostiju. Cilj istraživanja je utvrditi načine i mjesto prijeloma u populaciji djece Zadarske županije. Hipoteza rada je da nema bitnog odstupanja u epidemiologiji i liječenju ovih prijeloma. Provedena je retrospektivna analiza u petogodišnjem vremenskom razdoblju od 2014. do 2018. godine gdje je evidentirano 1476 djece koja su liječena u Općoj bolnici u Zadru pod MKB šiframa S52,5-S52.7 koje odgovaraju prijelomima donjeg dijela podlaktice. U istraživanju je najviše bilo dječaka 950 (63,6%), djevojčica 526 (36,4%). Najzastupljenija je dobna skupina od 5-9 godina, a prosječna dob dječaka je 9,7 godina, a djevojčica 9,5 godina. Razlika u dobi između dječaka i djevojčica iznosi samo 2 mjeseca što se razlikuje od drugih studija gdje je dobna razlika oko 1,5 godine. Najčešći način stradavanja je pad na ruku za vrijeme sportske aktivnosti 54,3%, najčešće je pogođena desna ruka 59,1%. Iznenađenje istraživanja je da je kod djevojčica češće bila pogođena lijeva ruka 63,5%. Od sportova djeca najviše stradavaju za vrijeme igranja nogometa 43%, a postoji jasan pokazatelj da i djevojčice sve više stradavaju na ovaj način jer je ženski nogomet sve popularniji u ovoj županiji. Najčešće mjesto prijeloma je metafiza (47%) i donji dio dijafize (22%) kostiju podlaktice. Liječenje ovog prijeloma je konzervativno 92%, a 8% djece je zahtijevalo hospitalizaciju radi repozicije kostiju u općoj anesteziji ili operacijskog zahvata. Od operacijskih zahvata najviše se korist perkutana stabilizacija ulomka žicom (73%) a manje se koriste tehnike osteosinteze TEN-om i otvorenom osteosintezom. Vrijeme liječenja u bolnici iznosi 1,3 dana, a ambulantno liječenje traje prosječno 26 dana. Na fizikalnu rehabillitaciju upućeno je 11% djece. Rezultati liječenja u 94% slučajeva su potpuni oporavak funkcije ruke. Prevencija ovog prijeloma može se postići boljom edukacijom sportskih trenera, djece, roditelja, nošenjem zaštitnih ortoza i prilagodbom dječjih igrališta sigurnijem boravku djece.The forearm fractures are the most common fractures of childhood. The most common cause of the fractures at this age is the fall in the extended arm where the axial part of the lower bones emerges. The aim of the research is to determine the ways and location of fractures in the population of Zadar County children. The hypothesis of work is that there is no significant difference in epidemiology and the treatment of these fractures. Retrospective analysis was carried out over a five-year period from 2014 to 2018, where 1476 children were treated in the General Hospital in Zadar under MKB code S52,5-S52.7 corresponding to the fractures of the lower forearm. In the study, the highest number of boys was 950 (63.6%), girls 526 (36.4%). The most common age group is 5-9 years old, and the average age of boys is 9.7 years, and the girl is 9.5 years old. The difference between the age of boys and girls is only 2 months, which differs from other studies where the age difference is about 1.5 years. The most common way of injury is a drop in hand during sports activities 54.3%, the most commonly affected right hand is 59.1%. Surprisingly, 63.5% of left-handed women were more affected by girls. Of the sports, children are most affected by playing football 43%, and there is a clear indication that girls are increasingly injured in this fashion as women's football is increasingly popular in this county. The most common site of the fracture is metaphysis (47%) and lower part of the dijax (22%) of the forearm bone.Treatment of this fracture was conservatively 92%, and 8% of children required hospitalization for bone repositioning in general anesthesia or surgery. Of the surgical procedures, the most favored by the percutaneous staging of the wire fragment (73%) and the lesser the techniques of osteosynthesis with TEN and open osteosynthesis. The treatment time in the hospital is 1.3 days, and the outpatient treatment lasts for an average of 26 days. Physical rehabilitation was sent to 11% of children. The results of the treatment in 94% of cases are complete recovery of the hand function. Prevention of this fracture can be achieved by better training of sports coaches, children, parents, wearing protective orthoses and adapting children's playgrounds to a more secure stay of children