Pathogenetic Justification in the Treatment of Transcondylar Fractures of the Humerus аmong Children

Askar Kasymzhanov, Zharylgasyn Bektasov, Agabek Chikinaev, Alexander Angelov

2022

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DOI 10.52889/1684-9280-2022-2-62-38-43
Data confidence 70 medium
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Abstract

The aim of the study was to evaluate the effectiveness of the use of closed reposition and osteosynthesis in the treatment of transcondylar fracture of the humerus among children.Methods The analysis of the immediate and long-term results of treatment of 321 children with transcondylar fractures of the humerus with displacement in the period from 6 months to 2 years was carried out. Evaluation of the results of treatment of children with transcondylar fractures was carried out according to the four-point system proposed by A.E. Erekeshov (2000). Results. In the study, excellent (45%) and good (52.5%) treatment results were predominantly noted. In 2 patients, after open surgical treatment, limitation of movements in the elbow joint to 15-20 degrees was noted, the result was stated as satisfactory (2.5%). Of the complications - in 3 cases, neuritis of the radial (2) and median (1) nerves was detected, associated with the severity of the injury and significant displacement of fragments in 1 patient and iatrogenic damage during osteosynthesis according to Pappus - 2 cases. Thus, satisfactory results were 2.5%, complications - 3.75%. After the rehabilitation treatment, the function of the nerves in these patients fully recovered after 6 months.Conclusion In case of unstable transcondylar fractures, the separation of fragments, the reposition should be performed under the control of the EOP and osteosynthesis should be carried out using Pappu spokes. The main requirement for achieving stable osteosynthesis is the passage of the spokes through the opposite cortical layer. The most optimal way of fixation is to hold the crossed spokes at an angle of 45 degrees, providing stable osteosynthesis.Keywords: pediatric traumatology, transcondylar fractures, humerus, reposition, osteosynthesis.