[Fractures of the diaphysis of the humerus in children.].
Diaphyseal fractures of the humerus are not common in children. With the exception of fractures which occur during delivery they do not differ substantially from diaphyseal fractures in adults as far as the etiology and line of fracture is concerned. They differ, however, substantially as regards treatment. At the Department for Paediatric Surgery, Thomayer Hospital during the period from January 1986 to December 1995, i.e. during a 10-year period, 66 were treated with injuries of the diaphysis of the humerus, which accounts for 6 % of all fractures of the humerus treated at the Department during the investigation period. One fifth was formed by pathological fractures, mostly in a juvenile bone cyst. In 61 instances (92, 5 %) conservative treatment was sufficient, using a Desault bandage reinforced with a plaster splint or treatment with suspended plaster or reposition under general anaesthesia with subsequent fixation. In some instances traction was used, skeletal or skin traction. Only in five instances an operation was performed. Osteosynthesis was used once using external fixation, once using an AO splint, twice using an intermedulla-ry procedure according to Hackethal and once by intramedullary fixation by Métaizeau's method. Except for one case, where monotrauma with a lesion of the radial nerve was involved, in all instances patients with multiple injuries were operated. In all children, treated by conservative methods or osteosynthesis, recovery was satisfactory without functional sequelae. The only exception was a patient with osteogenesis imperfecta who had, due to the basic disease, repeated fractures and developed typical deformities of both humeri. Only in two patients (3 %) a posttraumatic lesion of the radial nerve was recorded. Key words: humerus, diaphysis, fracture, child.
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Klinika detské chirurgie Fakultní Thomayerovy nemocnice, Praha.
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