Court-Brown C M, Byrnes T, McLaughlin G
Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, University of Edinburgh, Lauriston Place, Edinburgh EH3 9 YW, UK.
Injury. 2003 Oct;34(10):781-5. doi: 10.1016/s0020-1383(03)00060-3.
An analysis of 36 adolescent patients who presented with tibial diaphyseal fractures and open tibial physes has been undertaken. All patients were treated by reamed intramedullary nailing using a hollow, slotted nail. They were examined clinically and radiologically for late evidence of the effects of premature physeal closure secondary to nailing damage, but none were found. The speed of union in Tscherne C0 and C1 fractures in 13-16-year-old patients is highlighted and shown to be considerably faster than in adult patients. The speed of union in Tscherne C2 fractures is similar in adolescents and adults. The relatively high incidence of compartment syndrome in this age group is noted. Intramedullary nailing of tibial diaphyseal fractures in adolescents with open physes, using a slotted nail, appears to be safe and does not cause late growth problems.
对36例出现胫骨干骨折且胫骨骨骺开放的青少年患者进行了分析。所有患者均采用空心开槽髓内钉进行扩髓髓内钉固定治疗。对他们进行了临床和放射学检查，以寻找因钉损伤导致骨骺过早闭合影响的晚期证据，但未发现此类情况。强调了13 - 16岁患者中Tscherne C0和C1骨折的愈合速度，并表明其明显快于成年患者。青少年和成年患者中Tscherne C2骨折的愈合速度相似。注意到该年龄组骨筋膜室综合征的发病率相对较高。使用开槽髓内钉对骨骺开放的青少年胫骨干骨折进行髓内钉固定似乎是安全的，且不会导致后期生长问题。
