vmireavizВестник медицинского института «РЕАВИЗ». Реабилитация, Врач и ЗдоровьеBulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)2226-762X2782-1579РЕАВИЗ10.20340/vmi-rvz.2024.5.CLIN.1vmireaviz-1082Research ArticleКлиническая медицинаClinical medicineПереломы дистального метафиза плечевой кости у детей: этиопатогенез, клиника, диагностика, лечениеPediatric distal metaphysis fractures of the humerus: etiopathogenesis, clinical features, diagnostics, treatmenthttps://orcid.org/0000-0003-0171-0584АмаириО. Н.AmairiO. N.

Амаири Омар Наелович, врач травматолог ортопед травматологического отделения №1, Детская республиканская клиническая больница; ассистент кафедры травматологии, ортопедии и хирургии экстремальных состояний, Казанский государственный медицинский университет

ул. Орен6ургский тракт, д. 140, г. Казань, Респу6лика Татарстан, 420138,

ул. Бутлерова, д. 49, г. Казань, Респу6лика Татарстан, 420012

Omar N. Amairi, Traumatologist orthopedist of the traumatology department No. 1, Children's Republican Clinical Hospital; assistant of the department of traumatology, orthopedics and surgery of extreme conditions, Kazan State Medical University

140 Orenburg tract str., Kazan, Republic of Tatarstan, 420138, 

49 Butlerova str., Kazan, Republic of Tatarstan, 420012

omar_amairi@yahoo.comhttps://orcid.org/0000-0002-4910-8835АхтямовИ. Ф.AkhtyamovI. F.

Ильдар Фуатович Ахтямов. д-р мед. наук, профессор, заведующий кафедрой травматологии, ортопедии и хирургии экстремальных состояний

ул. Бутлерова, д. 49, г. Казань, Респу6лика Татарстан, 420012

Il'dar F. Akhtyamov, Dr. Sci. (Med.), Professor, Head of the Department of Traumatology, Orthopedics and Surgery of Extreme Conditions

49 Butlerova str., Kazan, Republic of Tatarstan, 420012

yalta60@mail.ruЦойИ. В.TsoyI. V.

Игорь Владимирович Цой, канд. мед. наук, врач травматолог ортопед, заведующий травматологическим отделением № 1

ул. Орен6ургский тракт, д. 140, г. Казань, Респу6лика Татарстан, 420138

Igor' V. Tsoy, Cand. Sci. (Med.), traumatologist-orthopedist, head of the traumatology department No. 1

140 Orenburg tract str., Kazan, Republic of Tatarstan, 420138

icoy2004@mail.ruАндреевП. С.AndreevP. S.

Петр Степанович Андреев, канд. мед. наук, врач травматолог ортопед, травматологического отделения

ул. Орен6ургский тракт, д. 140, г. Казань, Респу6лика Татарстан, 420138

Petr S. Andreev, Cand. Sci. (Med.), traumatologist orthopedist, traumatology department

140 Orenburg tract str., Kazan, Republic of Tatarstan, 420138

 

andreev_petr_s@mail.ruДетская республиканская клиническая больница; Казанский государственный медицинский университетРоссияChildren's Republican Clinical Hospital; Kazan State Medical UniversityRussian FederationКазанский государственный медицинский университетРоссияKazan State Medical UniversityRussian FederationДетская республиканская клиническая больницаРоссияChildren's Republican Clinical HospitalRussian Federation2024040920241455363Copyright © Амаири О.Н., Ахтямов И.Ф., Цой И.В., Андреев П.С., 20252025Амаири О.Н., Ахтямов И.Ф., Цой И.В., Андреев П.С.Amairi O.N., Akhtyamov I.F., Tsoy I.V., Andreev P.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestnik.reaviz.ru/jour/article/view/1082

Актуальность. Переломы дистального метафиза плечевой кости – самые распространённые среди травм костей локтевого сустава у детей, наблюдаются в 64–70% случаев. Цель — обобщение, систематизация литературных данных и представление современных взглядов на эпидемиологию, этиологию, патогенез, диагностику и лечение надмыщелковых и чрезмыщелковых переломов плечевой кости у детей. Материалы и методы. Системный поиск литературы был проведён по базам данных PubMed, PubMed Central, Web of Science, Scopus, MEDLINE, eLIBRARY, РИНЦ, Google Scholar, Cyberleninka, eLibrary и др. В исследование включались публикации о переломах дистального метафиза плечевой кости, лечении надмыщелковых и чрезмыщелковых переломов плечевой кости у детей в возрастной категории от 1 года до 17 лет включительно. Результаты. Дистальные метефизарные переломы плечевой кости являются самыми частыми среди переломов локтевого сустава у детей. Лечение переломов без смещения I-типа по Gartland проводится консервативно. Предпочтительным методом лечения переломов со смешением (типа II, III и VI по Gartland) является закрытая репозиция с чрескожным остеосинтезом спицами. При неуспешных попытках выполнения закрытой репозиции или при развитии серьёзных сосудисто-неврологических нарушений применяется открытая репозиция с ревизией области перелома. Оперативные вмешательства с остеосинтезом дистальных переломов плечевой кости в разы увеличились за последние годы, но значительно уменьшилось количество корригирующих остеотомий в лечении посттравматических деформаций. Заключение. Правильный подход в диагностике и лечении дистальных метефизарных переломов плечевой кости у детей, разумный выбор метода оперативного лечения и техники остеосинтеза обеспечивают положительные результаты лечения, уменьшают риск развития осложнений на протяжении всех этапов периода лечения.

Backgrоund

Backgrоund. Distal metaphysis fractures of the humerus in children are the most common among elbow joint injuries in children, occurring in 64–70%. Aim. Generalization of literature data and presentation of modern views on epidemiology, etiology, pathogenesis, diagnostics and treatment of supracondylar humeral fractures in children.

Materials and methods

Materials and methods. A systematic literature search was conducted using the following databases: PubMed,  PubMed  Central,  Web  of  Science,  Scopus,  MEDLINE,  eLIBRARY,  RINTS,  Google  Scholar, Cyberleninka, eLibrary, etc. The inclusion criteria were publications on fractures of the distal metaphysis of the humerus, treatment of supracondylar fractures of the humerus in children aged 1–17 years.

Results

Results. Distal metaphysis fractures of the humerus are the most common among elbow joint fractures in children. Treatment of non-displaced fractures Gartland type I is  conservative. The preferred method of treatment for displaced fractures Gartland types (II, III and VI) is closed reduction with percutaneous pinning osteosynthesis. In case of unsuccessful attempts to perform closed reduction, or in case of development of serious neurovascularal disorders, open reduction with revision of the fracture area is used. Surgical interventions with osteosynthesis of distal humerus fractures have increased several times in recent years, but the number of corrective osteotomies in the treatment of post-traumatic deformities has significantly decreased.

Conclusions

Conclusions. The correct approach in the diagnostics and treatment of pediatric distal metaphyseal fractures of the humerus, a reasonable choice  of  surgical  treatment  method  and  osteosynthesis  technique  ensure positive treatment results and reduce the risk of complications throughout all stages of the treatment period.

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The authors declare that there are no conflicts of interest present.