Abstract

Introduction Periarticular injuries in children include types I and II fractures according to the Salter-Harris classification and metaphyseal fractures. In most cases, conservative treatment is an effective method, but in some cases, surgical treatment, including external fixation, is the method of choice. Purpose Discussion of the principles of using the Ilizarov apparatus in the treatment of children with periarticular fractures of various locations, its advantages and disadvantages. Materials and methods We present the principles and features of the Ilizarov surgical techniques for treatment of children with periarticular fractures of the distal humerus, femur, radius and tibia. Discussion The methods of osteosynthesis for pediatric periarticular fractures imply transphyseal introduction of fixators that have a potential threat of iatrogenic damage to the growth plate in contrast to external fixation which performance implies that transosseous elements do not injure the growth zone, providing stable fixation of bone fragments in combination with early functional recovery of the damaged segment which is a key advantage over other methods. Conclusion The use of the Ilizarov apparatus enables to achieve the desired result in the treatment of pediatric periarticular fractures and has a number of advantages over other methods of surgical treatment.

Highlights

  • Periarticular injuries in children include types I and II fractures according to the Salter-Harris classification and metaphyseal fractures

  • The purpose of the study was to discuss the principles of using the Ilizarov apparatus in the treatment of children with juxta-articular fractures of various locations

  • A “lightweight” version of the Ilizarov apparatus can be used: one ring support is used at the level of the proximal fragment and the transosseous elements that pass through the distal fragment are fixed on threaded rods (Fig. 1)

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Summary

Introduction

Periarticular injuries in children include types I and II fractures according to the Salter-Harris classification and metaphyseal fractures. Certain requirements dictated by the childhood must be met: exclusion of iatrogenic significant damage to the growth plate, adequate reduction, minimal surgical aggression, ensuring stability of fixation even with a comminuted fracture, early restoration of the function of the damaged segment and the general activity of the child. These requirements present certain limitations for the surgeon in choosing the method of surgical treatment. All of the above excludes the use of traditional internal fixators [13, 16, 29–33]

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