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 nadlaktične kosti u djece – okolnosti i uzroci nastanka [Fracture of the humerus in children – causes and mechanisms of injury]

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. The high incidence of fractures justifi es questioning the possible prevention of this injury. Preventive actions are possible only with the knowledge of the causes and circumstances of the fracture. Aim 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 from 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 right hand was affected more frequently. Nearly 80% of fractures were unstable, which generally require 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

Prijelomi nadlaktične kosti u djece – okolnosti i uzroci nastanka [Radius fractures in children - causes and mechanisms of injury]

Radius fractures are the most common fractures in childhood. The main mechanism of injury is fall onto an outstretched hand. This retrospective study analyzed the data on 201 children admitted for radius fractures at KBC-Zagreb in the period 2011-2013. The study included 85 girls (42.3%) and 116 boys (57.7%) . The average age of the children was 9.6 years. Radius was injured in the distal segment in 79.1% of children. The sites of injuries were: park, campi and beach (24.9% of all children), playground, skate park and swimming pool (23.9%), kindergarten or school (20.9%), at home and around the house (17.9%), in the street (11.4%) and in the store or at a hotel (0.9%). The boys were mostly injured at playgrounds, during skating and at swimming pools (37.1% of all boys), while girls were mostly injured in parks, camps and at beach (42.4% girls). Fall was the major cause of the injury (49.3%), and children usually fell during ice skating and skating (32.3% of all falls). In 20.4% the injury was caused by pushing and hitting. The smallest percentage (9.5%) of children were injured in traffic accidents while riding a bike (only one child was hit by a car). Sport related activities caused injuries in 53.7% of the cases. Sport activities are the most important cause of the radial fractures in the pediatric population and falls during sports are the main mechanism of injury. The peak incidence is at 12 years for boys and at 10 years for girls, so intervention and/or prevention should be aimed at the age groups. Preventive actions should be focused on injuries that tend to occur in parks, schools and during sport activities

FRACTURE OF THE HUMERUS IN CHILDREN – CAUSES AND MECHANISMS OF INJURY

Zbog hiperaktivnosti djeca su često izložena ozljedama nadlaktice, a prijelomi nadlaktične kosti i nakon operativnog liječenja mogu ostaviti trajne posljedice. Visoka pojavnost prijeloma opravdava propitivanje o mogućoj prevenciji nastanka. Preventivna postupanja moguća su jedino uz poznavanje uzroka i okolnosti nastanka prijeloma. Cilj je ovog rada analizirati okolnosti nastanka, kritična mjesta i aktivnosti djece pri prijelomu nadlaktične kosti prema dobnim skupinama. U radu je analizirano 102-je djece liječene u KBC-u Zagreb zbog prijeloma nadlaktične kosti, u periodu od 2010. do 2014. U studiji je analizirano 45 djevojčica (44%) i 57 dječaka (56%). Prosječna dob djece iznosila je 8,3 godine. Prijelomi ­distalne trećine nadlaktične kosti čine 4/5 svih analiziranih prijeloma. Nešto je češće bila zahvaćena desna ruka. Gotovo 80% prijeloma bilo je nestabilno i oni su redovito nalagali operacijsko liječenje. Najviše ozlijeđenih bilo je u dobi od 5 do 9 godina. Najčešće su se ozljede događale na rekreacijskome mjestu (47%), zatim kod kuće (31%), 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 ozlijedila se u sportskim ili rekreacijskim aktivnostima. Daleko najčešće stradaju djeca u predškolskoj i ranoj školskoj dobi u igri i kontaktu s drugom djecom slične dobi. Kako bi se smanjila učestalost ovakvih ozljeda, preventivne aktivnosti treba usmjeriti prema najugroženijoj dobnoj skupini (5 – 9 godina) kod dnevnih aktivnosti pod nadzorom roditelja, ali i povećati nadzor u predškolskim i školskim ustanovama. Od svih aktivnosti najopasniji za nastanak prijeloma nadlaktične kosti jesu sportska igrališta i mjesta rekreativnih aktivnosti predškolske djece 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. 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. Aim 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 from 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 right hand was affected more frequently. Nearly 80% of fractures were unstable, which generally require ­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

Prijelomi kostiju šake u djece – okolnosti i uzroci nastanka [Hand fractures in children - causes and mechanisms of injury]

Hand is extremely exposed to various loads and traumas of everyday tasks and activities, resulting in fist fractures being fairly common injuries. The most common mechanism of injury is a direct blow. This retrospective study analyzed the data on 274 children admitted for hand fractures at Clinical Hospital Center Zagreb in the period from 2006 to 2014. The study included 76 girls (28%) and 198 boys (72%). The average patient age was 11.9 years and most were between 10 and 13 years of age. Phalangeal fractures accounted for 80%, metacarpal fractures for 17%, and carpal fractures for 3% of all injuries. Most commonly injuries occurred during recreation (4 1%), at home (37%), at school (18%) and in the street (4%). Direct blow was the major cause of injury (76%), and 24% were caused by fall. Injuries during sport activities are the most common cause of the hand fractures in pediatric population and direct blow is the main mechanism of injury. The peak incidence is at the age of 10-13 years in boys and girls, so prevention should be aimed at this age group. Preventive actions should be focused on injuries that tend to occur in parks, schools and during sport activities

RADIUS FRACTURES IN CHILDREN – CAUSES AND MECHANISMS OF INJURY

Izoliran ili zajedno s ulnom, prijelom palčane kosti jedan je od najčešćih prijeloma dječje dobi. Pretežiti mehanizam nastanka ove ozljede jest pad na ispruženu ruku. Visoka pojavnost prijeloma opravdava propitivanje o mogućoj prevenciji nastanka. Preventivna postupanja moguća su jedino uz poznavanje uzroka i okolnosti nastanka prijeloma. Cilj je ovog rada analizirati okolnosti nastanka i kritična mjesta nastanka prijeloma palčane kosti po dobnim skupinama. U radu je analizirano 201 dijete liječeno u KBC-u Zagreb s prijelomom palčane kosti, u periodu od 2011. do 2013. U studiji je analizirano 85 djevojčica (42,3%) i 116 dječaka (57,7%). Prosječna dob djece iznosila je 9,6 godina. Najčešće je prijelom u distalnom dijelu (79,1%) palčane kosti. Mjesta gdje su djeca stradala bila su: park, kamp i plaža (24,9% djece), igralište, klizalište i bazeni (23,9%), škola, vrtić ili jaslice (20,9%), kod kuće i oko kuće (17,9%), na ulici (11,4%) te u trgovini ili hotelu (0,9%). Dječaci stradavaju najviše na igralištima, klizanju i na bazenima (37,1% dječaka), dok djevojčice najviše stradavaju u parkovima, kampovima i na plažama (42,4% djevojčica). Način nastanka ozljede uglavnom je pad (49,3%) koji je najčešće nastao klizanjem i koturaljkanjem (rolanjem) (32,3% svih padova). U 20,4% djece uzrok ozljede su guranje i udarac. Najmanji postotak (9,5%) djece ozlijeđen je u prometu i to vozeći bicikl. Sportske su aktivnosti uzrok nastanka ozljede u 53,7% slučajeva. One su najvažniji uzrok nastanka ozljede palčane kosti u dječjoj populaciji i padovi u toku sporta glavni su mehanizam nastanka ozljede. Dječaci najviše stradavaju u dobi od 12 godina, a djevojčice u dobi od 10 godina pa su to dobne skupine u kojima je potrebno najviše djelovati. Preventivno djelovanje potrebno je usmjeriti na ozljede nastale u parkovima, školi i sportskim aktivnostima.Radius fractures are the most common fractures in childhood. The main mechanism of injury is fall onto an outstretched hand. This retrospective study analyzed the data on 201 children admitted for radius fractures at KBC-Zagreb in the period 2011–2013. The study included 85 girls (42.3%) and 116 boys (57.7%) . The average age of the children was 9.6 years. Radius was injured in the distal segment in 79.1% of children. The sites of injuries were: park, campi and beach (24.9% of all children), playground, skate park and swimming pool (23.9%), kindergarten or school (20.9%), at home and around the house (17.9%), in the street (11.4%) and in the store or at a hotel (0.9%). The boys were mostly injured at playgrounds, during skating and at swimming pools (37.1% of all boys), while girls were mostly injured in parks, camps and at beach (42.4% girls). Fall was the major cause of the injury (49.3%), and children usually fell during ice skating and skating (32.3% of all falls). In 20.4% the injury was caused by pushing and hitting. The smallest percentage (9.5%) of children were injured in traffic accidents while riding a bike (only one child was hit by a car). Sport related activities caused injuries in 53.7% of the cases. Sport activities are the most important cause of the radial fractures in the pediatric population and falls during sports are the main mechanism of injury. The peak incidence is at 12 years for boys and at 10 years for girls, so intervention and/or prevention should be aimed at the age groups. Preventive actions should be focused on injuries that tend to occur in parks, schools and during sport activities

Prijelom palčane kosti u djece – okolnosti i uzroci nastanka [Radius fractures in children – causes and mechanisms of injury]

Radius fractures are the most common fractures in childhood. The main mechanism of injury is fall onto an outstretched hand. This retrospective study analyzed the data on 201 children admitted for radius fractures at KBC-Zagreb in the period 2011–2013. The study included 85 girls (42.3%) and 116 boys (57.7%) . The average age of the children was 9.6 years. Radius was injured in the distal segment in 79.1% of children. The sites of injuries were: park, campi and beach (24.9% of all children), playground, skate park and swimming pool (23.9%), kindergarten or school (20.9%), at home and around the house (17.9%), in the street (11.4%) and in the store or at a hotel (0.9%). The boys were mostly injured at playgrounds, during skating and at swimming pools (37.1% of all boys), while girls were mostly injured in parks, camps and at beach (42.4% girls). Fall was the major cause of the injury (49.3%), and children usually fell during ice skating and skating (32.3% of all falls). In 20.4% the injury was caused by pushing and hitting. The smallest percentage (9.5%) of children were injured in traffic accidents while riding a bike (only one child was hit by a car). Sport related activities caused injuries in 53.7% of the cases. Sport activities are the most important cause of the radial fractures in the pediatric population and falls during sports are the main mechanism of injury. The peak incidence is at 12 years for boys and at 10 years for girls, so intervention and/or prevention should be aimed at the age groups. Preventive actions should be focused on injuries that tend to occur in parks, schools and during sport activities