PRIJELOMI PODLAKTICE U ZAGREBAČKE DJECE

Anko Antabak, Kristina Bračić, Klara Karlo, Krešimir Bulić, Dino Papeš, Goran Augustin, Stanko Ćavar, Tomislav Luetić

Prijelomi podlaktice najčešći su prijelomi dječje dobi. Pad na ispruženu ruku glavni je mehanizam ozljeđivanja. Velika pojavnost i mogući loši ishodi opravdavaju propitivanje preventivnih mjera pri nastanku ovih ozljeda. Za uspješnu prevenciju potrebno je znati mjesta i načine nastanka prijeloma. Cilj je ovog rada istražiti mjesta i načine nastanka prijeloma kostiju podlaktice u skupini zagrebačke djece. U retrospektivnu analizu uključeno je 395-ero djece s prijelomom kostiju podlaktice, liječene u KBC-u Zagreb u periodu od 1. siječnja 2014. godine do 19. listopada 2017. godine. U ispitanoj je skupini bilo 265 dječaka (67,1%) i 130 djevojčica (32,9%). Srednja životna dob iznosila je 9,1 godinu. Djevojčice su u prosjeku bile mlađe od dječaka 16 mjeseci. Najviše je djece – njih 175-ero (44,3%) bilo u dobnoj skupini od 5. do 9. godine života. Prijelom samo distalnog dijela radijusa imalo je 104-ero (26%) djece, distalnog dijela obiju kosti podlaktice također njih 104-ero (26%), a prijelom dijafize obiju kosti 94-ero (23,6%) djece. Glavni način nastanka prijeloma u skupini naše djece bio je pad – u njih 248-ero (62,8%). Prijevoz je uzrokovao 61 prijelom (15,4 %), a udarac 86 (21,8 %) prijeloma. Na prometnicama je nastalo osam (2%) prijeloma, kod kuće 25 (6,3%), u školi 37 (9,3%), a na prostorima za izvannastavne aktivnosti i slobodno vrijeme 271 (68,7%) prijelom. Od toga na igralištu/u parku nastalo je 69 (26,2%) prijeloma, pri vožnji biciklom 54 (13,7%), a tijekom igranja nogometa 46 (11,7%). Od 69-ero djece koja su prijelome podlaktice zadobila na igralištu ili u parku kod njih 39-ero (56,5%) to se dogodilo tijekom igre na ljuljački, toboganu i trampolinu. Dječaci padaju češće od djevojčica: gotovo tri puta češće u razini i dva puta s male visine. Djevojčice ozljede češće zadobiju pri padu s bicikla. Zaključno, dječaci su višestruko češće ugroženi, a dominantan način ozljeđivanja jest pad. Pretežito se radi o djeci predškolske i rane školske dobi. Stoga društvena zajednica treba posebnu pozornost usmjeriti upravo na tu djecu tijekom njihovih rekreativnih i sportskih aktivnosti (vožnja biciklom i igranje nogometa). U zagrebačke djece igrališta i parkovi najčešća su mjesta prijeloma podlaktice.

Forearm fractures are the most common fractures of childhood. Fall on the extended arm is the main mechanism of injury. High incidence and possible poor outcomes of treatment justify the questioning of preventative measures in the occurrence of these injuries. The aim of this paper is to investigate the sites and ways of forearm fracture of in a group of Zagreb children. This retrospective study included 395 children from the city of Zagreb who were hospitalized in the UHC Zagreb from January 1, 2014 to October 19, 2017. The examined group included 265 boys (67.1%) and 130 girls (32.9%). The average life expectancy was 9.1 years. Girls were on average 16 months younger than boys . The highest number of children was 175 (44.3%) in the age group 5-9 years.. One hundred and four (26%) children had fractures of only the distal part of the radius, 104 (26%) of the distal part of both forearm bones, and 94 (23.6%) diaphyseal fracture of both bones . The leading cause of fractures in our children group was fall (248 – 62.8%). Transport caused 61 (15.4%), and blow 86 (21.8%) fractures in the group of our children. There were eight (2%) fractures on the roads, 25 (6.3%) at home, 37 (9.3%) at school, and 271 (68.7%) in extracurricular activities and leisure time. Out of these, there were 69 fractures on the playground or in the park (26.2%), 54 (13.7%) in bike ride , and 46 (11.7%) during football. Of the 69 children who had forearm fracture on the playground or in the park, 39 (56.5%) suffered a break on a swing, toboggan and trampoline. Boys often fall, almost three times more on same level, and twice more from low hight than girls. Girls are more often injured by falling from the bike. In conclusion, boys are more often at risk, and the dominant mode of injury is falling. Mostly, they are children of pre-school and early school age. Special community engagement should focus on these children during their recreational and sporting activities (cycling and football). In Zagreb, children’s play areas and parks are the most common places of forearm fracture occurrence.