Distal radius epiphysiolysis

Prijelom distalnog dijela palčane kosti najčešći je prijelom u dječjoj dobi. Pri prijelomu može doći do prijeloma epifize radijusa – epifizeolize. U 4 – 5 % slučajeva epifizeoliza može rezultirati poremećajem rasta palčane kosti u duljinu te trajnim estetskim i funkcionalnim defektima. Najčešći mehanizam nastanka ove ozljede je pad na ispruženu ruku. Dijagnoza se postavlja anamnezom, fizikalnim pregledom i rentgenskim snimanjem. Liječi se imobilizacijom ako nema pomaka. U suprotnom provodi se operativno liječenje – zatvorena repozicija i imobilizacija pod općom anestezijom. Teži slučajevi liječe se otvorenom repozicijom i unutarnjom fiksacijom, pomoću Kirschnerove žice ili vijka. Ovo retrospektivno istraživanje uključilo je 180 pedijatrijskih pacijenata, s prijelomom distalnog dijela palčane kosti liječenim u KBC-u Zagreb. Cilj istraživanja bio je prikazati uzroke prijeloma distalnog dijela palčane kosti u djece, s osvrtom na uzroke epifizeolize distalnog radijusa. Studija je obuhvatila 125 dječaka (68,68 %) i 57 djevojčica (31,32 %). Tri je velikih skupina uzroka prijeloma: pad, ozljeda u prometu i udarac. U prvoj, najvećoj, skupini najviše se djece ozlijedilo padom u razini, i to tijekom igre ili pri sportu. Ozljeda u prometu najčešće je uzrokovana tijekom vožnje bicikla. U trećoj, najmanjoj, skupini udarac je obično zadobiven djelovanjem lopte. Epifizeoliza distalnog radijusa evidentirana je u 61 slučaju (33,89 %). Uzroci epifizeolize po svojoj su učestalosti jednaki gore navedenima. Većina djece liječena je zatvorenom repozicijom i imobilizacijom pod općom anestezijom. Preventivnim djelovanjem mogu se spriječiti dugoročne posljedice prijeloma distalnog radijusa i epifizeolize distalnog radijusa. Poznavanje uzroka preduvjet je preventivnom djelovanju.Distal radius fracture is the most frequent fracture among children. Distal radius epiphysiolysis can occur in such a fracture. In 4 to 5 % epiphysiolysis may result in growth disturbances, leading to permanent aesthetic and functional flaws. It is diagnosed by history, physical examination and X-ray imaging. It is treated with immobilization, in case a displacement exists. Otherwise, an operation consisting of closed reduction and immobilization under general anaesthesia is needed. Severe cases are treated with open reduction and internal fixation, using a Kirschner wire or a screw. This retrospective study included 180 minor patients that were diagnosed with distal radius fracture and treated in University Hospital Centre Zagreb. The aim of this research was to analyse the causes of distal radius fractures, as well as the causes of distal radius epiphysiolysis. The study included 125 boys (68,68 %) and 57 girls (31,32 %). There are three major groups of fracture causes: a fall, a traffic-related injury and a blow. In the first, largest group the majority of children injured themselves by falling on the same level during sports or play. Traffic-related injuries were mostly caused during cycling. In the third, smallest group the blow was usually caused by a ball. Distal radius epiphysiolysis was diagnosed in 61 cases (33,89 %). The aetiology of epiphysiolyses is identical to those mentioned above. Most of the children were treated with closed reduction and immobilization under general anaesthesia. Preventive action is needed in order to avoid permanent consequences of distal radius fractures and distal radius epiphysiolysis. The awareness of causes of these injuries is a prerequisite to preventing them from happening

Distal radius epiphysiolysis

Prijelom distalnog dijela palčane kosti najčešći je prijelom u dječjoj dobi. Pri prijelomu može doći do prijeloma epifize radijusa – epifizeolize. U 4 – 5 % slučajeva epifizeoliza može rezultirati poremećajem rasta palčane kosti u duljinu te trajnim estetskim i funkcionalnim defektima. Najčešći mehanizam nastanka ove ozljede je pad na ispruženu ruku. Dijagnoza se postavlja anamnezom, fizikalnim pregledom i rentgenskim snimanjem. Liječi se imobilizacijom ako nema pomaka. U suprotnom provodi se operativno liječenje – zatvorena repozicija i imobilizacija pod općom anestezijom. Teži slučajevi liječe se otvorenom repozicijom i unutarnjom fiksacijom, pomoću Kirschnerove žice ili vijka. Ovo retrospektivno istraživanje uključilo je 180 pedijatrijskih pacijenata, s prijelomom distalnog dijela palčane kosti liječenim u KBC-u Zagreb. Cilj istraživanja bio je prikazati uzroke prijeloma distalnog dijela palčane kosti u djece, s osvrtom na uzroke epifizeolize distalnog radijusa. Studija je obuhvatila 125 dječaka (68,68 %) i 57 djevojčica (31,32 %). Tri je velikih skupina uzroka prijeloma: pad, ozljeda u prometu i udarac. U prvoj, najvećoj, skupini najviše se djece ozlijedilo padom u razini, i to tijekom igre ili pri sportu. Ozljeda u prometu najčešće je uzrokovana tijekom vožnje bicikla. U trećoj, najmanjoj, skupini udarac je obično zadobiven djelovanjem lopte. Epifizeoliza distalnog radijusa evidentirana je u 61 slučaju (33,89 %). Uzroci epifizeolize po svojoj su učestalosti jednaki gore navedenima. Većina djece liječena je zatvorenom repozicijom i imobilizacijom pod općom anestezijom. Preventivnim djelovanjem mogu se spriječiti dugoročne posljedice prijeloma distalnog radijusa i epifizeolize distalnog radijusa. Poznavanje uzroka preduvjet je preventivnom djelovanju.Distal radius fracture is the most frequent fracture among children. Distal radius epiphysiolysis can occur in such a fracture. In 4 to 5 % epiphysiolysis may result in growth disturbances, leading to permanent aesthetic and functional flaws. It is diagnosed by history, physical examination and X-ray imaging. It is treated with immobilization, in case a displacement exists. Otherwise, an operation consisting of closed reduction and immobilization under general anaesthesia is needed. Severe cases are treated with open reduction and internal fixation, using a Kirschner wire or a screw. This retrospective study included 180 minor patients that were diagnosed with distal radius fracture and treated in University Hospital Centre Zagreb. The aim of this research was to analyse the causes of distal radius fractures, as well as the causes of distal radius epiphysiolysis. The study included 125 boys (68,68 %) and 57 girls (31,32 %). There are three major groups of fracture causes: a fall, a traffic-related injury and a blow. In the first, largest group the majority of children injured themselves by falling on the same level during sports or play. Traffic-related injuries were mostly caused during cycling. In the third, smallest group the blow was usually caused by a ball. Distal radius epiphysiolysis was diagnosed in 61 cases (33,89 %). The aetiology of epiphysiolyses is identical to those mentioned above. Most of the children were treated with closed reduction and immobilization under general anaesthesia. Preventive action is needed in order to avoid permanent consequences of distal radius fractures and distal radius epiphysiolysis. The awareness of causes of these injuries is a prerequisite to preventing them from happening

Analiza prašine nastale piljenjem sadrenih udlaga

Plaster splints are used daily in surgical and orthopedic fields in order to immobilize injured children and adults. The aim of this study was to measure the aerodynamic diameter and concentration of dust particles in the air caused by sawing plaster splints (calcium sulfate dehy-drate). We performed fractional measurements of airborne dust particles. The measured particles, which can potentially be inhaled, may have a specific negative effect on human health. Measurements were conducted in laboratory research facilities that simulated hospital conditions within a casting room and the associated waiting room. Measurements within the casting room were made using two particle collector devices and one laser photometer. The measurement for the simulated waiting room was performed using the same principles and devices. The collected plaster dust particles differed in aerodynamic diameter and concentration according to the various locations observed. The highest concentration of particles of all sizes was recorded at the site of cast sawing. There was direct correlation between distance from the source and concentration of airborne particles; this concentration was lowest in the waiting room. The concentrations of plaster dust recorded were lower than the recommended minimal limit values for total and respiratory fractions in Croatia. Accordingly, it can be assumed that sawing of plaster splints has no harmful health effects on the exposed patients and health personnel.Sadrene udlage se svakodnevno rabe u kirurškoj i ortopedskoj praksi prilikom imobilizacije ozlijeđene djece i odraslih. Cilj ovoga rada bio je izmjeriti aerodinamički promjer i koncentraciju čestica prašine u zraku nastale piljenjem sadrenih udlaga (kalcijev sulfat dihidrat). Učinjeno je frakcionirano mjerenje lebdećih čestica prašine. Izmjerene frakcije, ovisno o respirabilnosti čestica, mogu imati određeno negativno djelovanje na ljudsko zdravlje. Mjerenja su provedena u laboratorijskim uvjetima, uz simulaciju bolničkih prostorija gipsaonice i njene čekaonice. Mjerenja u gipsaonici izvršena su pomoću dva para sakupljača čestica i jednog laserskog fotometra. Mjerenje u čekaonici provedeno je na jednak način. Prikupljena prašina po mjernim mjestima razlikuje se po aerodinamičkom promjeru i koncentraciji čestica gipsa u zraku. Najviše koncentracije čestica svih veličina zabilježene su neposredno uz mjesto piljenja. Na ostalim mjernim mjestima koncentracija čestica opada s udaljenošću od izvora prašine pri čemu je koncentracija prašine bila najniža u čekaonici. Zabilježene koncentracije prašine gipsa niže su od propisanih graničnih vrijednosti za ukupnu i respiracijsku frakciju u Hrvatskoj. Na temelju toga razumno je pretpostaviti da za vrijeme piljenja sadrenih udlaga nema štetnog učinka na zdravlje izloženih bolesnika i zdravstvenog ­osoblja

Prijelomi distalnog radijusa u djece – uzroci i mjesta nastanka [Distal radius fractures in children – causes and places of occurrence]

Distal radius fractures are the most common fractures in children and account for about 25% of all fractures. The main mechanism of occurrence is a fall on the outstretched hand. These fractures usually occur as a result of accidents, and rarely because of injuries and pathological conditions. In this retrospective study, we analyzed 182 hospital-treated distal radius fractures, of which 61 fractures (29.8%) represent epiphysiolysis. The causes are divided into three groups: fall 124 (68.1%), injuries in traffic 50 (27.5%), and strikes 8 (4.4%). Falls usually occur during sport or game playing 72 (39.6%), and traffic injuries occur during cycling 30 (52%) and roller skating 25 (43%). Children were most often injured in the areas of sports and recreational activities 115 (63%), on the street 38 (21%), and at the school 16 (9%). In our children the highest incidence of distal radius fractures was during sports and recreational activities, and the lowest in school and at home

DISTAL RADIUS FRACTURES IN CHILDREN – CAUSES AND PLACES OF OCCURRENCE

Prijelomi distalnog dijela radijusa najčešći su prijelomi u djece i čine oko 25% svih prijeloma. Glavni mehanizam nastanka je pad na ispruženu ruku. Ovi prijelomi najčešće nastaju kao posljedica nesretnih slučajeva, a rjeđe zbog ozljeda i patoloških stanja. U ovom retrospektivnom istraživanju analizirali smo 182 bolnički liječena prijeloma distalnog radijusa, od čega 61 (29,8%) otpada na epifizeolize. Uzroci su podijeljeni u tri skupine: pad 124 (68,1%), ozljeda u prometu 50 (27,5%) i udarac 8 (4,4%). Padovi najčešće nastaju tijekom igre ili sporta – 72 (39,6%), a prometne ozljede tijekom vožnje bicikla – 30 (52%) i koturaljki – 25 (43%). Djeca su se najčešće ozljeđivala na mjestima sportske i rekreacijske aktivnosti – 115 (63%), na ulici 38 (21%) te u školi 16 (9%). U naše djece najveća je pojavnost prijeloma distalnog radijusa tijekom sportskih i rekreacijskih aktivnosti, a najmanja u školi i kod kuće.Distal radius fractures are the most common fractures in children and account for about 25% of all fractures. The main mechanism of occurrence is a fall on the outstretched hand. These fractures usually occur as a result of accidents, and rarely because of injuries and pathological conditions. In this retrospective study, we analyzed 182 hospital-treated distal radius fractures, of which 61 fractures (29.8%) represent epiphysiolysis. The causes are divided into three groups: fall 124 (68.1%), injuries in traffic 50 (27.5%), and strikes 8 (4.4%). Falls usually occur during sport or game playing 72 (39.6%), and traffic injuries occur during cycling 30 (52%) and roller skating 25 (43%). Children were most often injured in the areas of sports and recreational activities 115 (63%), on the street 38 (21%), and at the school 16 (9%). In our children the highest incidence of distal radius fractures was during sports and recreational activities, and the lowest in school and at home

Distal radius epiphysiolysis

Prijelom distalnog dijela palčane kosti najčešći je prijelom u dječjoj dobi. Pri prijelomu može doći do prijeloma epifize radijusa – epifizeolize. U 4 – 5 % slučajeva epifizeoliza može rezultirati poremećajem rasta palčane kosti u duljinu te trajnim estetskim i funkcionalnim defektima. Najčešći mehanizam nastanka ove ozljede je pad na ispruženu ruku. Dijagnoza se postavlja anamnezom, fizikalnim pregledom i rentgenskim snimanjem. Liječi se imobilizacijom ako nema pomaka. U suprotnom provodi se operativno liječenje – zatvorena repozicija i imobilizacija pod općom anestezijom. Teži slučajevi liječe se otvorenom repozicijom i unutarnjom fiksacijom, pomoću Kirschnerove žice ili vijka. Ovo retrospektivno istraživanje uključilo je 180 pedijatrijskih pacijenata, s prijelomom distalnog dijela palčane kosti liječenim u KBC-u Zagreb. Cilj istraživanja bio je prikazati uzroke prijeloma distalnog dijela palčane kosti u djece, s osvrtom na uzroke epifizeolize distalnog radijusa. Studija je obuhvatila 125 dječaka (68,68 %) i 57 djevojčica (31,32 %). Tri je velikih skupina uzroka prijeloma: pad, ozljeda u prometu i udarac. U prvoj, najvećoj, skupini najviše se djece ozlijedilo padom u razini, i to tijekom igre ili pri sportu. Ozljeda u prometu najčešće je uzrokovana tijekom vožnje bicikla. U trećoj, najmanjoj, skupini udarac je obično zadobiven djelovanjem lopte. Epifizeoliza distalnog radijusa evidentirana je u 61 slučaju (33,89 %). Uzroci epifizeolize po svojoj su učestalosti jednaki gore navedenima. Većina djece liječena je zatvorenom repozicijom i imobilizacijom pod općom anestezijom. Preventivnim djelovanjem mogu se spriječiti dugoročne posljedice prijeloma distalnog radijusa i epifizeolize distalnog radijusa. Poznavanje uzroka preduvjet je preventivnom djelovanju.Distal radius fracture is the most frequent fracture among children. Distal radius epiphysiolysis can occur in such a fracture. In 4 to 5 % epiphysiolysis may result in growth disturbances, leading to permanent aesthetic and functional flaws. It is diagnosed by history, physical examination and X-ray imaging. It is treated with immobilization, in case a displacement exists. Otherwise, an operation consisting of closed reduction and immobilization under general anaesthesia is needed. Severe cases are treated with open reduction and internal fixation, using a Kirschner wire or a screw. This retrospective study included 180 minor patients that were diagnosed with distal radius fracture and treated in University Hospital Centre Zagreb. The aim of this research was to analyse the causes of distal radius fractures, as well as the causes of distal radius epiphysiolysis. The study included 125 boys (68,68 %) and 57 girls (31,32 %). There are three major groups of fracture causes: a fall, a traffic-related injury and a blow. In the first, largest group the majority of children injured themselves by falling on the same level during sports or play. Traffic-related injuries were mostly caused during cycling. In the third, smallest group the blow was usually caused by a ball. Distal radius epiphysiolysis was diagnosed in 61 cases (33,89 %). The aetiology of epiphysiolyses is identical to those mentioned above. Most of the children were treated with closed reduction and immobilization under general anaesthesia. Preventive action is needed in order to avoid permanent consequences of distal radius fractures and distal radius epiphysiolysis. The awareness of causes of these injuries is a prerequisite to preventing them from happening

Analysis of Airborne Dust as a Result of Plaster Cast Sawing

Plaster splints are used daily in surgical and orthopedic fields in order to immobilize injured children and adults. The aim of this study was to measure the aerodynamic diameter and concentration of dust particles in the air caused by sawing plaster splints (calcium sulfate dehy-drate). We performed fractional measurements of airborne dust particles. The measured particles, which can potentially be inhaled, may have a specific negative effect on human health. Measurements were conducted in laboratory research facilities that simulated hospital conditions within a casting room and the associated waiting room. Measurements within the casting room were made using two particle collector devices and one laser photometer. The measurement for the simulated waiting room was performed using the same principles and devices. The collected plaster dust particles differed in aerodynamic diameter and concentration according to the various locations observed. The highest concentration of particles of all sizes was recorded at the site of cast sawing. There was direct correlation between distance from the source and concentration of airborne particles; this concentration was lowest in the waiting room. The concentrations of plaster dust recorded were lower than the recommended minimal limit values for total and respiratory fractions in Croatia. Accordingly, it can be assumed that sawing of plaster splints has no harmful health effects on the exposed patients and health personnel