Stevens Peter M, Pease Felicity
Department of Orthopedic Surgery, University of Utah School of Medicine, Primary Children's Medical Center, Salt Lake City, UT 84113, USA.
J Pediatr Orthop. 2006 May-Jun;26(3):385-92. doi: 10.1097/01.bpo.0000206515.84577.70.
Posttraumatic tibial valgus is a recognized complication of proximal tibial metaphyseal fractures in children. There is no consensus regarding management of this malalignment; approaches range from repeated osteotomy to therapeutic nihilism. The authors present 12 patients with an average age at fracture of 4 years 11 months, each of whom who was successfully managed by temporary hemiepiphysiodesis. An additional patient (age 33 years) is included to illustrate the potential long-term outcome of "benign neglect."Using staples or, more recently, a 2-hole plate for guided growth, we have demonstrated correction of posttraumatic tibial valgus by all criteria; including mechanical axis deviation, lateral tibial metaphyseal-diaphyseal angle, tibiofemoral angle, and tibial length. We conclude that hemiepiphysiodesis is a safe and effective method of treatment with a high degree of patient/parent satisfaction. There have been no permanent growth arrests.
创伤后胫骨外翻是儿童胫骨近端干骺端骨折公认的并发症。对于这种畸形的治疗尚无共识；治疗方法从反复截骨到治疗虚无主义不等。作者报告了12例骨折时平均年龄为4岁11个月的患者，每例均通过临时半骨骺阻滞术成功治疗。还纳入了1例33岁的患者以说明“保守治疗”的潜在长期结果。使用U形钉或最近使用的双孔钢板进行引导生长，我们已通过所有标准证明创伤后胫骨外翻得到了矫正；包括机械轴偏差、胫骨外侧干骺端-骨干角、胫股角和胫骨长度。我们得出结论，半骨骺阻滞术是一种安全有效的治疗方法，患者/家长满意度高。没有出现永久性生长停滞。
