Damages of locomotor apparatus in children as a result of road accidents

Aim. To study the specific features of locomotor apparatus injuries and to improve the surgical tactics of treatment using low invasive osteosynthesis techniques in case of road accidents among children.

Materials and methods. The results of surgical treatment of 35 children (age range 2 to14 years) after road accidents were studied at the pediatric traumatology and orthopedics unit. Associated multisystem injuries of the locomotor system constituted 77,1 %. Clinicoroentgenological data, MRT and CT indices were studied. Vegetative dysfunction was assessed. All the patients underwent low invasive surgical intervention with minimized surgical approach, including elastic intramedullary nails, closed transcutaneous pin osteosynthesis under electro-optic transducer control, transosseous osteosynthesis.

Results. All the patients were operated, 80 % of them were operated during the first day after the admission to the hospital. It resulted in early arrest of pain syndrome, fast normalization of vegetative function, prevented the development of traumatic disease or stopped its manifestations. All the results of surgical treatment were estimated as positive. Insignificant contractures were observed in 2 patients after the distal comminuted fracture of the shoulder with decrease in movement amplitude at the level of elbow joint within 15%; no disability was noted; no slowed consolidation and false joints were registered.

Conclusions. Low invasive techniques provide optimal conditions for osseous consolidation and positive functional outcome after road accidents. It is recommended to take into account the status of vegetative functions in patients with associated multisystem injuries.