Operative treatment of radial neck fractures in children.

INTRODUCTION: Injuries to the ulnar joint area are common musculoskeletal injuries in children. Among them, proximal radial bone fractures are characterized by a variety of treatment methods applied and a risk of complications. OBJECTIVE: The aim of the present paper is to present the types and treatment results of proximal radial bone fractures in children. MATERIAL AND METHODS: The present study is based on data obtained from the medical histories of 28 patients treated in the years 2006-2010. The clinical parameters analysed included the extent of bone fragment displacement, age and sex of the patient, and type and result of the operative treatment. RESULTS: Types and results of the operative treatment are presented based on post-operative clinical follow-up of 2 to 5 years. CONCLUSIONS: 1. Paediatric radial neck fractures occur primarily in adolescents and children at early school age, and the fracture line extends within the growth plate area. 2. The treatment results allow us to conclude that closed reduction of a radial neck fracture with intramedullary stabilization (ESIN) eliminates complications and provides for earlier restoration of the range of motion in the ulnar joint.

"Syndrome of contractures" (according to Mau) with the abduction contracture of the right hip as causative factor for development of the so-called idiopathic scoliosis.

The article provides basic explanation of "syndrome of contractures" (Mau) at newborns and babies and it's conjunction with biomechanical etiology of the so-called idiopathic scoliosis (Karski 1995-2006). The authors analyzed children with "syndrome of contractures" and noted its relevance to some clinical symptoms at children with scoliosis. Newborns and babies with clinical signs of "syndrome of contractures" require further spine examination already at age of 3-4 in order to detect "danger of oncoming scoliosis" and to introduce neo-prophylaxis. The research based on "syndrome of contractures" can explain predominance of female gender of patients with scoliosis, sides of curves, side of rib hump, progression and sensibility to new rehabilitation exercises.

In-vitro mechanical impacts on calves' proximal femurs: significance of mechanical weakening of the femoral head in the etiology of Perthes disease in children.

Experimental research was conducted to determine the effects of mechanical forces on the hip joint in the etiology of Perthes disease in children. The authors aimed to identify areas of lower resistance to mechanical forces in a growing femoral head. Calves' femurs, used as experimental models, were repeatedly subjected to mechanical impacts. The results showed that the areas most susceptible to trauma were the layers of immature bone located underneath the epiphyseal growth zone and underneath the growth plate. The authors conclude that blood vessels in these areas are highly vulnerable to mechanical damage, and the resulting impairment of blood flow to the femoral head leads to the development of Perthes disease in children.

"Contracture syndrome" in newborns and infants according to Prof. Hans Mau as an explanation of the "geography" and certain clinical features of idiopathic scoliosis.

Background. Many malformations and dysfunctions of the skeletal system are connected with the "contracture syndrome" described by Prof. Hans Mau. The clinical features include plagiocephaly, torticollis, infantile scoliosis, pelvic deformity, foot deformity, adductor contracture mostly of the left hip, abductor contracture mostly of the right hip. Material and methods. The authors analyzed 300 histories of children aged from 3 weeks to 12 months treated in the years 1999-2001, and 100 histories of children with idiopathic scoliosis. Conclusions. Newborns and babies with clinical features of "contracture syndrome" require further spinal examination at age 3-4 in order to detect the risk of incipient scoliosis and to introduce appropriate preventive measures.

New conservative treatment of idiopathic scoliosis: effectiveness of therapy.

Background. This article provides basic information concerning a new conservative treatment for idiopathic scoliosis, with appropriate asymmetric flexion-rotation exercises and special redressing positions. Material and method. The analysis was based on 288 children with scoliosis and a control group of 268 children. The authors describe the most important exercises and provide a statistical analysis of treatment outcome in children with idiopathic scoliosis. Results and Conclusions. Early detection of the risk of scoliosis and correct therapy through new conservative treatment based on exercises make it possible not only to limit the progression of spinal deformity (61%), but also, in some cases of incipient scoliosis, to reduce the curvature (32%).

Radiological picture of "unaffected" proximal femoral growth plate in children with unilateral Perthes disease.

Background. A changed radiological picture has Bern observed in the initial x-rays of the unaffected proximal femoral growth plate in children with unilateral Perthes disease. The present study seeks to determine whether a thicker, horizontal growth plate in an etiological factor in Perthes disease.
Material and methods. The research involved 173 children diagnosed with unilateral Perthes diseas, and a control group of 174 children aged 3-10. Alsberg's angle was measured to detect horizontal growth plate, while x-ray images were examined if the growth plate was thickened.
Results. In 15 of the children with unilateral Perthes disease, the unaffected growth plate was horizontal (Alsberg's anle 840-900); in 8 children, the growth plate was thicker and radiolucent, mostly on its lateral side. No clinical symptoms accompanied these changes in the unaffected hip joint in the children we studied. In the control group, horizontal growth plate was noticed in the case of child (Alsberg's angle 840).
Conclusions. Transient radiographic abnormalities of proximal femoral growth plate are risk factors for increased incidence of Perthes disease in children above 3 years of age. The reason for these transient abnormalities of femoral growth plates is probably temporary disturbance of the blood supply and mechanical strain before manifestation of the symptoms of Perthes disease.