Rezultati liječenja prijeloma klavikula u djece

Treatment of clavicle fracture is principally outpatient. Operative treatment is accompanied by the need for more x-rays and possible complications. Fractures with absolute indications for operative treatment occur only sporadically and these indications are relatively clear, but children often undergo surgery because of relative indications (shortening, fragment displacement, multifragmentary fractures), which are open to debate. In a retrospective study on 256 children, of 44 (17%) patients that received operative treatment only one 17-year-old boy had an absolute indication for surgical intervention. Other indications were fragment distraction (22 mm on average), age, associated injuries, and multifragmentary fracture. The placement of K-wire of appropriate thickness is often difficult, since the wire tends to bend and break, and patients have to undergo two additional operations of plate and screw fixation and later removal. In this retrospective study, we considered the advantages of using titanium or an elastic steel pin. All patients had favorable outcome, although some experienced numbness around the operation scar (4.5%), skin infections around the wire (15%), and/or the implanted K-wire damage (7%).Liječenje fraktura klavikule je prevenstveno ambulantno. Operativno liječenje zahtijeva dodatne rentgenske snimke i praćeno je mogućim komplikacijama. Frakture s apsolutnom indikacijom za operativno liječenje se pojavljuju sporadično i te indikacije su jasne, ali često djeca budu operirana zbog relativnih indikacija koje nisu sasvim jasne. U retrospektivnoj studiji na 256 djece, od kojih je 44 (17%) operativno liječeno, samo jedan dječak od 17 godina je imao apsolutnu indikaciju za operaciju. Ostale indikacije su bile distrakcija (prosječno 22 mm), dob, udružene ozljede i multifragmentarne frakture. Postavljanje Kirschnerove žice odgovarajuće debljine je često nemoguće zbog savijanja i pucanja žice pa bolesnici moraju ići na dva dodatna zahvata, fiksaciju pločicom i vijcima i vađenje osteosintetskog materijala. U sklopu ove studije razmotrili smo prednosti korištenja titanskog čavla. Svi bolesnici su imali dobar ishod, iako se u određenom broju operiranih pojavila utrnutost oko ožiljka (4,5%), infekcija rane (15%) i oštećenje Kirschnerove žice (7%)

RB 005 Guide to McGovern Collection on the History of Medicine

The McGovern Collection contains over 5,500 titles focused on the development of the medical specialties in the late nineteenth century and early twentieth. There are significant sections on pediatrics, allergy and cardiology. The collection emphasis has been American Imprints and English language materials. There are a small number of titles in French or German from the eighteenth century. See more at RB 005