SOME REGULARITIES OF PRONATION SUBLUXATION OF THE RADIAL HEAD IN CHILDREN

Abstract

The relevance of the research topic. The frequency of joint bone dislocations in children, according to the literature, is 1–2% of all injuries. In all cases, there is damage to the periarticular structures, which causes significant functional disorders. The peculiarity of traumatic dislocations in children is that such dislocations must be corrected immediately in order to prevent the formation of joint contractures and limb deformities in the process of extremely intensive growth, which invariably causes secondary pathological changes in the child's musculoskeletal system. The aim of the study. To study the age, sex, seasonal patterns of pronation subluxation of the radial head in children with the aim of timely diagnosis, treatment and prevention of negative consequences of untimely treatment of these injuries. Materials and methods. The outpatient records of children treated at the TODKL of the TOR who received emergency care in 2020 were analysed. During the reporting period, 8,625 children received such assistance. Traumatic dislocations were diagnosed in 118 patients, which is 1.4% of all injuries. The examination of young patients was carried out according to the classical scheme: anamnesis, complaints, clinical examination data. The main and most informative method of additional examination was X-ray. Since almost all traumatic dislocations occurred in younger children, the role of parents in taking anamnesis was the main one. All pronation dislocations of the radius head in the elbow joint were treated in two stages. Results. The left and right arms were injured almost equally with a slight predominance of the left arm (65 children – 55.1%). The age structure was in the range of 1–5 years. At the age of 1 year there were 18 children (15.5%), 2 years – 41 (34.7%), 3 years – 41 (34.7%), 4 years – 53 (44.9%) and very rarely 0.8% after 5 years. Girls were injured more often (83 – 70.3%) than boys (35 – 29.7%). After 5 years of age, dislocations were rare, within 0.8%. A seasonal pattern of these injuries was identified. In January, there were 18 dislocations (15.3%), in February 12 (10.2%), and in March 16 (13.6%). In summer, there was a sharp decline in this injury: June – 8 (6.8%); July – 2 (1.7%); August – 7 (5.9%). In all cases, pronation subluxations of the radius head occurred with indirect force – pulling the arm with simultaneous pronation, extremely rarely – when falling on a straightened arm. All children were treated on an outpatient basis, there were no complications, they grew and developed according to their age. Conclusions. Pronation subluxation of the radial head in childhood is dominant. Mostly injured are girls (70.3%) aged 1–5 years. Timely repair of this damage guarantees full anatomical and functional restoration of the elbow joint.