Неосложненные переломы шейных позвонков у детей и подростков

Abstract

Introduction Various aspects of uncomplicated fractures of the cervical vertebrae in children and adolescents remain topical. Purpose To study incidence, character and type of uncomplicated fractures of the vertebrae of the cervical spine in children and adolescents. Materials and methods Out of 1000 children who had uncomplicated vertebral fractures, 27 (2.7 %) people were diagnosed with fractures at the cervical level. There were more boys among the injured – 77.77 % of the injured. 29.63 % of the patients were under the age of 12, and 70.37 % of – aged 12–17. Traditional methods for emergency traumatology were used for clinical diagnostics. Results In 17 (62.96 %) of the patients only the cervical vertebrae were compressed, in 10 (37.04 %) patients – both the thoracic vertebrae and the cervical vertebrae. Among the cervical vertebrae, compression of C7 vertebral body was most often observed – in 30.64 % of cases, less often – the body of C3 – in 4.08 % of cases. The main mechanism of injury was falling on head from a height of 2 m and more – 25.98 % of cases. Analysis of the character of C2 fractures showed that four patients had fractures of the odontoid process (three patients – type I, one – type III), one patient – fractures of the arches of this vertebra corresponding to type I. Fractures of subaxial location mainly corresponded to group "A" (subgroup I (36 compressed vertebrae), subgroup II (6 injured vertebrae)). In 2 cases, vertebral fractures were referred to group "B" (subgroup I). In 25 (92.59 %) clinical cases conservative treatment was used, in 2 (7.41 %) – there were indications for surgical treatment. The average duration of in-patient treatment for fractures of the cervical vertebrae was 9.4 days. Evaluation of long-term treatment results showed "good" results in 83.33 % of cases, satisfactory – in 16.67 % of clinical observations. Discussion The results that we have received are mainly comparable with the literature data on the main aspects of cervical trauma in children. At the same time, it is necessary to mention some differences. For example, many authors report that younger children most often get fractures of the C2 vertebra. According to our data, the average age of patients with these fractures was 14.8 years.