Backgrоund. Radial head subluxation is the most common injury in young children and accounts for 2.6% of the total population in this age group. In 39%82% of cases, the mechanism of injury is the traction of the arm, but subluxation can occur during a fall and in other circumstances; in 19%51% of cases, the mechanism of injury is unknown. Aim. The purpose of this study is to generalize and arrange the available literature and data and present current views on the prevalence, etiology, pathogenesis, diagnosis, and treatment of radial head subluxation in children. Materials and methods. A literature search was performed using the PubMed, PubMed Central, Google Scholar, CNKI-Scholar, Cyberleninka, and eLibrary databases. The sample of sources was mainly limited to 20002019. Results. The cause of subluxation is the displacement of the annular ligament and its interposition in the humeroradial joint. It is determined by a number of features of the elbow joint anatomy in young children. Diagnosis of radial head subluxation is based on history and clinical data; radiography and ultrasonography are used to obtain a clear clinical picture and to exclude fractures. The mainstay of treatment is a closed reduction, which is conducted via two methods as follows: supinationflexion and hyperpronation. According to modern research data, preference is given to the hyperpronation method; it is more effective in terms of number of reduction attempts, is technically simpler and, possibly, less painful. Generally, immobilization after effective reduction is not required as the function of the elbow joint is fully restored. A consequence of radial head subluxation is recurrence, which occurs in 5%46% of cases. A factor associated with recurrence is being less than two years of age. The prophylaxis of radial head subluxation is aimed at preventing forceful arm traction in children under three years of age and involves educating the parents or caregivers in the symptoms of subluxation to prevent late admission. Conclusions. Radial head subluxation is found in young children and is mainly diagnosed clinically. The treatment consists of a closed reposition, and the prognosis for restoring limb function is favorable.

Aim. The analysis of diagnostic and management measures offered for patients with traumatic hand amputations at different levels of rural healthcare. Methods. The medical charts of 115 patients [including 98 (85.2%) in-patients] aged 14 to 67 years with complete and incomplete traumatic hand amputation treated since 1985 to 2010 were analysed. Results. 81 (70.4%) of patients were of working age, 18 (15.7%) - adolescents (up to 18 years of age). 65 (56.5%) of patients were blue-collar workers, 6 (5.2%) - white-collar workers, 19 (16.5%) - students, 12 (10.4%) - unemployed, 13 (11.3%) - retired. Occupational injuries were registered in 25 (21.7%) of patients, including 24 (36.9%) blue-collar workers and 1 (16.7%) white-collar worker. Traumatic hand amputations due to incised wounds were registered in 1 (0.9%) case, due to bites - 1 (0.9%) case, due to chopped wound - in 26 (22.6%) cases, due to lacerated wounds - in 35 (30.4%) cases, due to high-energy trauma - in 45 (39.1%) cases. No trauma mechanism was registered in patient’s medical charts for 7 (6.1%) cases. Traumatic hand amputations at wrist level were registered in 2 (1.7%) cases, at finger level - in 113 (98.7%) cases. The primary care was provided in regional paramedic stations and regional hospitals to 71 (61.7%) patients. High-energy traumas had the most unfavorable clinical course and were associated with worst prognosis. The chosen reconstructive surgery type depended on the mechanism of trauma, wound shape and size and the condition of surrounding tissues. The local reconstructive surgery was the most frequent choice. Complications were observed in 11.2% of cases (in 27.1% of high-energy trauma cases). Patients became constantly disabled in 4.3% of cases. Most of the medical errors were made at primary care level, including unjustified rejection of wound debridement and improper finger stump debridement. Conclusion. To optimize the medical aid for patients with traumatic hand amputations a continuous theoretical training of medical staff, providing emergency care, in quarterly seminars, is needed. Patients with traumatic hand amputations should be admitted directly to the hospital emergency room, bypassing the outpatient services.