In 95 children (age 6-18 y) treated for gallstones between 2002-2010, 95 laparoscopic cholecystectomies were carried out. Symptomatic cholecystolithiasis was the indication for laparoscopic cholecystectomy in most of the cases. In three patients, there was a conversion to open cholecystectomy. Postoperative complications due to failure of bile drainage arose in three patients. Restored bile drainage was secured for two biliodigestive anastomosis. Bile leak in a third patient solved a temporary biliary stent. Laparoscopic cholecystectomy is the gold standard for gallstones (Ref. 8). Full Text in PDF www.elis.sk.
The risk of osseous bridge development after certain types of physeal injury is well established. Once formed, the bridge continues to grow and results in a progressive deformity. The authors present an unusual case of a five-year-old girl who had a Salter-Harris Type-IV fracture of the distal tibial epiphyseal plate, with subsequent osseous bridge formation and deformity development. The bridge resolved spontaneously in 16 months, and joint mechanical axis alignment was gradually restored with normal growth of the distal tibia.
Problematika prerastu zlomenej stehnovej kosti u detí pri operačnom ako aj konzervatívnom prístupe v liečbe je pomerne dobre zhodnotená (7,12,15). Existuje množstvo odborných publikácií na túto tému, avšak porovnávacie štúdie zahŕňajúce dlhodobé výsledky konzervatívnej verzus operačnej liečby sú ojedinelé (3,17). Našou snahou bolo posúdenie výskytu prerastu u zlomenín detského femuru pri použití elasticky stabilnej intramedulárnej osteosyntézy, a to jednak vo vzťahu ku konzervatívnej liečbe (prevládajúcej v našich podmienkach ešte v minulej dekáde), ako aj zhodnotenie výsky-tu prerastu v najmladších vekových skupinách, kam smerovali naše indikačné rozvahy po predchádzajúcich dobrých skúsenostiach s ESIN v skupine 6-ročných až 14-ročných pacientov.
SÚBOR PACIENTOV A METODIKASledovaný súbor tvorilo 49 pacientov (33 chlapcov, 16 dievčat) vo veku 4-17 rokov (priemer 10,1 roka), operovaných metódou ESIN v rokoch 2001 až 2005 pre diafyzárnu zlomeninu stehnovej kosti. Kontrolnú skupinu tvorilo 99 pacientov (63 chlapcov a 36 dievčat) vo veku 2-15 rokov (priemer 6,9 roka), liečených pre rovnakú
394/PŮVODNÍ PRÁCE ORIGINAL PAPER
We report the case of a 4-month-old infant with fracture-separation of the distal humeral epiphysis diagnosed on the basis of X-ray examination. Closed reduction was performed under ultrasound guidance. The effect of reduction was checked by computer tomography and magnetic resonance imaging and, under general anaesthesia, the arm was immobilised using a collar-and-cuff. Subsequently, percutaneous osteosynthesis with two 1.2-mm Kirschner wires through the radial condyle was carried out. The fracture was allowed to heal in a normal elbow position with plaster cast for 5 weeks. The duration of immobilisation had to be prolonged and removal of the wires postponed because the infant acquired a respiratory infection; the usual time for fracture union is 3 weeks. At 23 months after injury the outcome was excellent and the baby remained registered for a long-term follow-up.
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