Journal of hospital Pula, Vol. 2 No. 2, 2005.
Original scientific paper
EXPERIENCIES WITH CHILD FOREARM FRACTURES IN GENERAL HOSPITAL PULA
Rajko Ćelović
Dejvis Močenić
Vilijam Bilić
Abstract
To compare surgical and conservative treatment in proximal and distal forearm child fractures. The study compared 84 patients, aged 2-14 years, who were admitted to the hospital because of with forearm fracture. Criteria for the inclusion in the study were forearm fractures of 3/4 forearm bone. Children with proximal forearm fractures (N=45) were treated: conservative, manual reposition and immobilisation, primary operated within the first 24 hours n=16, secundary within the first 12 days n=11 after the fracture) and with distal forearm fractures (N= 39, conservative n=14, primary operated n=18 , secundary operated n=7). All patients with proximal and 31 patients with distal forearm fractures were treated with physiotherapy. We recorded immobilisation time, duration of physiotherapy and complete therapy. Functional improvement or deficite was assessed according «neutral-0-test«, degree of elbow, wrist movement and rotation of forearm. There were significant differences between primary and conservative treatment for proximal forearm fractures in duration of immobilisation (median 20 days, range18-24, vs median 49 days, range 30-58, respectively, p<0.05), all therapy (median 28 days, range 22-35, median 74 days range 63-81, respectively, p<0.05). The primary surgical group also had shorter physiotherapy. After primary surgical treatment we had lower functional deficit than in the conservative treatment (elbow index of movement median 1.04 , range 0.54-1.23 (median 3.42 range 2.98-3.64, p<0.05) and rotation index of forearm median 8.30 range 7.88-8.52 median (12.75 range 12.52-12.90). In distal forearm fractures there were significant differences between primary and secundary surgical treatment in immobilisation times (median 23 range 18-25 vs median 37 range 21-47, P<0.05), all therapy and physiotherapy (p<0.05). We had lower functional deficit after primary surgical treatment (wrist index movement median 2.87 range 2.01-3.28, 4.15 range 3.55-4.45, respectively p<0.005 and rotatio index median 1.84 range 1.56-2.00 median 2.95 range 2.56-3.24). Proximal forearm fractures caused bigger functional deficit than in a distal forearm. Primary surgery treatment can be recommended in proximal forearm fractures because after rehabilitation we had minimal functional deficit.
Keywords
Hrčak ID:
7633
URI
Publication date:
15.6.2005.
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