Fama G, Turra S, Bonaga S
Clinica Ortopedica Ospedale Civile, Padova.
Chir Organi Mov. 1992 Jul-Sep;77(3):247-56.
Traumatic lesions of the triradiate cartilage (TC) are a rare occurrence and at a high risk for premature closure with consequent acetabular dysplasia and subdislocation of the femoral epiphysis. Based on their experience (5 cases: 2 type II and 3 type V according to the Salter-Harris classification system) and on the literature, the authors affirm that the most significant prognostic factors of this acetabular dysplasia are the age of the patient (under 10 years) and the type of lesion (Salter-Harris type V). After emphasizing how difficult it is to make a diagnosis (which is often made later on), the authors take into consideration some traumatic lesions of the pelvis and hip which by means of different mechanisms may influence the TC: fracture of the ilio- and ischio-pubic branches, fracture of the neck and detachment of the proximal epiphysis of the femur, traumatic dislocation of the hip. These lesions are often the only indirect sign of lesion, even severe ones, of the TC, and require accurate diagnostic testing (ultrasonography, CAT, MRI).
髋臼三辐射软骨(TC)的创伤性损伤较为罕见,且存在过早闭合的高风险,进而导致髋臼发育不良和股骨头骨骺半脱位。基于他们的经验(5例:根据Salter-Harris分类系统,2例为II型,3例为V型)及文献,作者断言,这种髋臼发育不良最重要的预后因素是患者年龄(10岁以下)和损伤类型(Salter-Harris V型)。在强调做出诊断有多困难(诊断往往较晚做出)之后,作者考虑了一些骨盆和髋部的创伤性损伤,这些损伤可能通过不同机制影响TC:髂耻支和坐骨支骨折、股骨颈骨折及近端骨骺分离、髋关节创伤性脱位。这些损伤常常是TC损伤(甚至是严重损伤)的唯一间接征象,需要进行准确的诊断检查(超声、CT、MRI)。