Experience in the treatment of skeletal trauma associated with craniocerebral injuries in children

Experience in treatment of 125 children with limb fractures combined with craniocerebral injuries is presented. Algorithm of diagnostic measures to improve the quality of diagnosis was elaborated. Seventy one patients (56.8%) were treated conservatively: 54 patients with skeletal traction,6 patients with adhesive plaster traction,11 — with plaster of Paris traction. Fifty four patients (43.2%) underwent surgical treatment: 25 patients had intramedullar osteosynthesis,24 patients — fixation of fragments by pins,5 patients — by Ilizarov device. Long term results were assessed at 1—7 years follow-up. Results showed the efficacy of osteosynthesis in relation to skeletal traction. However, at early posttraumatic period when craniocerebral injury is extremely severe, surgical treatment should be limited by skeletal traction and plaster of Paris immobilization. Use of early osteosynthesis gives the decrease of hospitalization term by 7.8 day and fixation terms — by 10.2 day.