PRIJELOM PALČANE KOSTI U DJECE – OKOLNOSTI I UZROCI NASTANKA

Anko Antabak, Lana Stanić, Nikša Matković, Dino Papeš, Ivan Romić, Nino Fuchs, Tomislav Luetić

Izoliran ili zajedno s ulnom, prijelom palčane kosti jedan je od najčešćih prijeloma dječje dobi. Pretežiti mehanizam nastanka ove ozljede jest pad na ispruženu ruku. Visoka pojavnost prijeloma opravdava propitivanje o mogućoj prevenciji nastanka. Preventivna postupanja moguća su jedino uz poznavanje uzroka i okolnosti nastanka prijeloma. Cilj je ovog rada analizirati okolnosti nastanka i kritična mjesta nastanka prijeloma palčane kosti po dobnim skupinama. U radu je analizirano 201 dijete liječeno u KBC-u Zagreb s prijelomom palčane kosti, u periodu od 2011. do 2013. U studiji je analizirano 85 djevojčica (42,3%) i 116 dječaka (57,7%). Prosječna dob djece iznosila je 9,6 godina. Najčešće je prijelom u distalnom dijelu (79,1%) palčane kosti. Mjesta gdje su djeca stradala bila su: park, kamp i plaža (24,9% djece), igralište, klizalište i bazeni (23,9%), škola, vrtić ili jaslice (20,9%), kod kuće i oko kuće (17,9%), na ulici (11,4%) te u trgovini ili hotelu (0,9%). Dječaci stradavaju najviše na igralištima, klizanju i na bazenima (37,1% dječaka), dok djevojčice najviše stradavaju u parkovima, kampovima i na plažama (42,4% djevojčica). Način nastanka ozljede uglavnom je pad (49,3%) koji je najčešće nastao klizanjem i koturaljkanjem (rolanjem) (32,3% svih padova). U 20,4% djece uzrok ozljede su guranje i udarac. Najmanji postotak (9,5%) djece ozlijeđen je u prometu i to vozeći bicikl. Sportske su aktivnosti uzrok nastanka ozljede u 53,7% slučajeva. One su najvažniji uzrok nastanka ozljede palčane kosti u dječjoj populaciji i padovi u toku sporta glavni su mehanizam nastanka ozljede. Dječaci najviše stradavaju u dobi od 12 godina, a djevojčice u dobi od 10 godina pa su to dobne skupine u kojima je potrebno najviše djelovati. Preventivno djelovanje potrebno je usmjeriti na ozljede nastale u parkovima, školi i sportskim aktivnostima.

Radius fractures are the most common fractures in childhood. The main mechanism of injury is fall onto an outstretched hand. This retrospective study analyzed the data on 201 children admitted for radius fractures at KBC-Zagreb in the period 2011–2013. The study included 85 girls (42.3%) and 116 boys (57.7%) . The average age of the children was 9.6 years. Radius was injured in the distal segment in 79.1% of children. The sites of injuries were: park, campi and beach (24.9% of all children), playground, skate park and swimming pool (23.9%), kindergarten or school (20.9%), at home and around the house (17.9%), in the street (11.4%) and in the store or at a hotel (0.9%). The boys were mostly injured at playgrounds, during skating and at swimming pools (37.1% of all boys), while girls were mostly injured in parks, camps and at beach (42.4% girls). Fall was the major cause of the injury (49.3%), and children usually fell during ice skating and skating (32.3% of all falls). In 20.4% the injury was caused by pushing and hitting. The smallest percentage (9.5%) of children were injured in traffic accidents while riding a bike (only one child was hit by a car). Sport related activities caused injuries in 53.7% of the cases. Sport activities are the most important cause of the radial fractures in the pediatric population and falls during sports are the main mechanism of injury. The peak incidence is at 12 years for boys and at 10 years for girls, so intervention and/or prevention should be aimed at the age groups. Preventive actions should be focused on injuries that tend to occur in parks, schools and during sport activities.