CHARACTERISTICS OF THE FUNCTIONAL STATE OF THE NEUROMUSCULAR AND VASCULAR SYSTEMS DURING SURGICAL AND CONSERVATIVE TREATMENT OF HUMERAL SHAFT FRACTURES IN CHILDREN

Aim of the study is the functional recovery of the neuromuscular and vascular systems of the upper extremities in children with humeral shaft fractures after minimally invasive osteosynthesis with titanium rods and conservative treatment.

Material. An analysis of the functional state of the neuromuscular and vascular systems was conducted at various points in the recovery period in children (n = 20, average age 12,3 ± 2,5 years) with humeral shaft fractures treated with minimally invasive osteosynthesis using elastic rods (group 1, n = 10) and conservative osteosynthesis (group 2, n = 10). The control group consisted of 8 children of the same age without traumatological and orthopedic pathology.

Results. In all children with humeral shaft fractures, regardless of the treatment method, the most complete and intensive restoration of blood supply and motor function (by 4–6 months postoperatively) was observed in the muscles of the shoulder girdle (deltoideus, supraspinatus, and infraspinatus) on the fractured side. The functional state of the injured shoulder muscles (biceps brachii, triceps brachii) and the corresponding peripheral nerves (n. radialis, n. musculocutaneus) was restored later: no earlier than 9 and 12 months in both groups. Quantitative assessment of neuromuscular and vascular function at these time points indicated more complete recovery in patients in group I compared to patients in group II.

The use of neurophysiological and Dopplerographic research methods in children with fractures of the humeral diaphysis made it possible to determine the physiological mechanisms of restoration of neuromuscular and vascular functions in the process of reparative osteogenesis after minimally invasive surgical and conservative treatment, which allowed for timely correction of the rehabilitation plan aimed at restoring motor activity of the injured limb.

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