PERINATAL TRAUMATOLOGY: OUR FIRST EXPERIENCE OF SURGICAL TREATMENT OF FRACTURES OF LONG TUBULAR BONES IN NEWORNS

Abstract

The problem of treatment of fractures of long tubular bones in newborns is relevant due to the lack of unifed standards of rendering medical aid and lack of common criteria for the estimation of the treatment outcomes. The purpose of the study was to improve the treatment outcomes of fractures of long tubular skeletal bones in newborns obtained during the intranatal and postnatal periods using intramedullary osteosynthesis. Of 45,623 children born alive in 2016 and 2017, 4 (0.087%) newborns got fractures of humeral and femoral bones during the perinatal period. To establish the clinical diagnosis of traumatic bone lesions, methods of examination typical of emergency traumatology were used such as collection of complaints and anamnesis, clinical examination, radiography of the affected segment and paraclinical methods. Out of 4 children, one child underwent a conservative treatment whereas three newborns had surgeries. In all three clinical observations, unsuccessful closed manual fracture reposition with plaster immobilization and high probability of soft tissue trauma in a recurrent reposition were indications to surgeries. The scope of surgical treatment consisted in minimally invasive osteosynthesis of long tubular bone fracture under radiologic control. No complications were found in neither clinical observation following a surgery. Study of follow-up enabled to register satisfactory treatment results of humeral and femoral fractures in newborns.