Eid Abulfotooh M, Hafez Mohamed A
Department of Orthopaedics, Faculty of Medicine, University of Alexandria, Egypt.
Injury. 2002 Apr;33(3):251-5. doi: 10.1016/s0020-1383(01)00109-7.
This is a retrospective study on a series of 151 injuries involving the distal femoral physis. The average age at the time of injury was 12.3 years. Patients were followed for an average of 8.2 years. The complications encountered were not insignificant and the satisfactory results were relatively low (64.9%). The juvenile age group was the most affected with complications. Salter-Harris type II injuries predominated (43.0%) and they did not have a good prognosis as previously suggested. Symptomatic knee ligamentous laxity was found in 12 patients (7.9%). Compartment syndrome is a devastating complication that occurred in 2 cases (1.3%). We stress the point that a child with a physeal injury of the distal femur should be followed for several years after injury and preferably until skeletal maturity. The surgeon must have high index of suspicious for compartment syndrome. Physeal injuries of the distal femur and in particular Salter and Harris type II should be reduced anatomically and fixed well. Whether this should be achieved by closed or opened means, requires a controlled prospective study to provide a confident answer.
这是一项对151例涉及股骨远端骨骺损伤的回顾性研究。受伤时的平均年龄为12.3岁。患者平均随访8.2年。所遇到的并发症并非微不足道，满意结果相对较低（64.9%）。青少年年龄组受并发症影响最大。Salter-Harris II型损伤占主导（43.0%），且它们并不像之前所认为的那样预后良好。12例患者（7.9%）发现有症状性膝关节韧带松弛。骨筋膜室综合征是一种严重的并发症，发生在2例患者中（1.3%）。我们强调，股骨远端骨骺损伤的儿童在受伤后应随访数年，最好直至骨骼成熟。外科医生必须对骨筋膜室综合征有高度的怀疑指数。股骨远端的骨骺损伤，尤其是Salter-Harris II型损伤，应进行解剖复位并牢固固定。这是应通过闭合还是开放方式来实现，需要一项对照前瞻性研究来给出可靠答案。
