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Experimental research was conducted to determine the effects of mechanical forces on the hip joint in the etiology of Perthes disease in children. The authors aimed to identify areas of lower resistance to mechanical forces in a growing femoral head. Calves' femurs, used as experimental models, were repeatedly subjected to mechanical impacts. The results showed that the areas most susceptible to trauma were the layers of immature bone located underneath the epiphyseal growth zone and underneath the growth plate. The authors conclude that blood vessels in these areas are highly vulnerable to mechanical damage, and the resulting impairment of blood flow to the femoral head leads to the development of Perthes disease in children.
STRESZCZENIEWstęp. Ura zy oko li cy sta wu łok cio we go na le żą do czę stych uszko dzeń na rzą du ru chu u dzie ci. Spo śród nich zła ma nia bli ższe go od cin ka ko ści pro mie nio wej cha rak te ry zu je ró żno rod ność za sto so wa nych me tod le cze nia oraz ist nie ją ce ry zy ko po wi kłań.Cel pra cy. Pre zen ta cja ro dza jów i wy ni ków le cze nia zła mań bli ższe go od cin ka ko ści pro mie nio wej u dzie ci. Ma te riał i me to dy. Ba da nia opar te są na da nych uzy ska nych z hi sto rii cho rób 28 pa cjen tów le czo nych w latach 2006-2010. Ana li za ma te ria łu kli nicz ne go obej mo wa ła sto pień prze miesz cze nia odła mu, wiek, płeć pacjen ta oraz ro dzaj i wy nik za sto so wa ne go le cze nia ope ra cyj ne go.Wy ni ki. Na pod sta wie ob ser wa cji kli nicz nej obej mu ją cej okres 2-5 lat od za bie gu ope ra cyj ne go przed stawio no ro dza je i wy ni ki za sto so wa ne go le cze nia ope ra cyj ne go.Wnioski. 1. Zła ma nia szyj ki ko ści pro mie nio wej u dzie ci do ty czą głów nie pa cjen tów w wie ku mło dzień -czym i wcze snosz kol nym, a li nia zła ma nia roz cią ga się w ob rę bie chrząst ki wzro sto wej. 2. Uzy ska ne wy ni ki le cze nia po zwa la ją na stwier dze nie, że za mknię ta re po zy cja zła ma nia szyj ki ko ści pro mie nio wej ze śród sz pi kową jej sta bi li za cją (ESIN) skut ku je bra kiem po wi kłań i wcze śniej szym po wro tem ru chów w sta wie łok cio wym. Słowa kluczowe: złamania, kość promieniowa, dzieci SUMMARYBackground. Injuries to the ulnar joint area are common musculoskeletal injuries in children. Among them, proximal radial bone fractures are characterized by a variety of treatment methods applied and a risk of complications.Objective. The aim of the present paper is to present the types and treatment results of proximal radial bone fractures in children.Material and methods. The present study is based on data obtained from the medical histories of 28 patients treated in the years 2006-2010. The clinical parameters analysed included the extent of bone fragment displacement, age and sex of the patient, and type and result of the operative treatment.Results. Types and results of the operative treatment are presented based on post-operative clinical followup of 2 to 5 years.Conclusions. 1. Paediatric radial neck fractures occur primarily in adolescents and children at early school age, and the fracture line extends within the growth plate area. 2. The treatment results allow us to conclude that closed reduction of a radial neck fracture with in tramedullary stabilization (ESIN) eliminates com plications and provides for earlier restoration of the range of motion in the ulnar joint.
the posterior cruciate ligament (PcL) plays a relevant role in maintaining proper mechanical stability of the knee joint. Avulsion fracture of the tibial insertion of the PcL is a very rare injury in children. Despite of clinical signs, radiologic studies are fundamental for its correct diagnosis and treatment. Its might be treated either conservative or operative. In children population there are not too many scientific studies which circumscribed such injury. therefore, we still do not know what is the most effective treatment for avulsion fracture of tibial insertion of the PcL. the case we describe is a classical avulsion fracture of the tibial insertion of the PcL with accurate diagnosis and the surgical treatment followed by short follow-up control. the lesion was fixed with the screw through an open posterior approach with anatomic reduction. the patient has been closed followed for 6 months with extreme good results such as: stable painless knee and excellent functional outcome.
Assuming the mechanical significance of injuries in the etiopathogenesis of Osgood-Schlatter and Sever-Haglund diseases, it should be recognized that the areas susceptible to damage in growing apophyses are the growth zones and the newly formed bone. The SMI Doppler ultrasound (visualization of microvascular flows) helps to determine the precise location of the lesion, i.e. the area of the greater vascular microflow within the involved apophyses. The ultrasound examination revealed increased microflows within the growth zones of painful apophyses. On the "healthy" side, no microflows were observed. Relief of pain in the tibial tuberosities and the heel correlated with a marked reduction in the vasculature of the previously painful outgrowths. The authors suggest that as regards the imaging studies in Osgood-Schlatter and Sever-Haglund diseases, in the future, the most crucial method may be with Doppler ultrasound with microvascular visualization.
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