Closed Fractures of the Distal Part of the Shin Bones. Different Types and Methods of the Treatment in Adolescence. Short Period Results

Abstract

Background.Fractures of the distal leg bones in children, due to the peculiarities of localization, the presence of a growth zone, the proximity of the joint and the involvement of the ligamentous apparatus in the pathological process, present a difficult problem in the choice of treatment and rehabilitation.Aims:In order to our aims we create the diagnostic and treatment algorithm in the system of early rehabilitation after fractures in the distal part of the shin bone in adolescence.Methods.Our clinical investigation based on the treatment of 56 patients in the age 817 years. Cohort of patients consist from three age groups: 811 years (n=13), 1214 years (n=28) and 1517 years (n=15). Examination was done with X-rays, CT and Ultrasound, specialy in the cases where the damage of ligamentous apparatus was suspicious. The main method of treatment was surgical osteosynthesis by pins, plates and screws. In the rehabilitation period the legs were immobilized by Plaster of Paris for 46 weeks.Results.In majority of cases the outcomes in the period of 68 weeks after trauma were good and satisfactory. The method of laser Doppler fluometry was performed in 16 cases in follow up period after trauma for examination of the regional blood circulation as a argumentation of regeneration process.Conclusion.The different choice in treatment of compound fractures of the distal part of the shin bones according to morphological changes in adolescence permits to aid good results in majority of caces.