Briggs T W, Orr M M, Lightowler C D
Institute of Orthopaedics, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.
Injury. 1992;23(5):308-10. doi: 10.1016/0020-1383(92)90175-r.
In a review of 65 tibial fractures in children of which 25 were isolated and not associated with a fracture of the fibula, we found that isolated tibial fractures were not uncommon, and accounted for one-third of all tibial fractures in children under 11 years of age. They occur after two types of force, the most common being indirect violence involving a torsional injury. Isolated fractures unite easily without delayed union. Isolated transverse fractures never displace, and consequently do not require further radiographs following the initial check radiograph after the application of the plaster cast. In seven of the 25, the fracture was spiral or oblique and displacement into varus occurred for up to 2 weeks after the initial injury. These need careful follow-up, with weekly radiographs for the first 2 weeks. If the varus displacement is greater than 5 degrees we recommend manipulation in that period. After this time the fracture site is sticky, and manipulation will fail. Non-operative treatment is recommended for this fracture.
在一项对65例儿童胫骨骨折的回顾性研究中，其中25例为单纯性骨折，不伴有腓骨骨折，我们发现单纯性胫骨骨折并不罕见，占11岁以下儿童所有胫骨骨折的三分之一。它们由两种类型的外力导致，最常见的是涉及扭转损伤的间接暴力。单纯性骨折易于愈合，不会出现延迟愈合。单纯性横行骨折从不发生移位，因此在石膏固定后的初次检查X线片后无需进一步拍摄X线片。在25例中的7例中，骨折为螺旋形或斜形，初始损伤后长达2周出现内翻移位。这些需要仔细随访，最初2周每周拍摄X线片。如果内翻移位大于5度，我们建议在此期间进行手法复位。在此之后骨折部位已粘连，手法复位将失败。对于这种骨折，建议采用非手术治疗。
