Kowalczyk Bartłomiej, Lejman Tadeusz
Oddział Ortopedyczno-Urazowy, Uniwersytecki Szpital Dzieciecy Uniwersytetu Jagiellońskiego w Krakowie.
Chir Narzadow Ruchu Ortop Pol. 2007 Nov-Dec;72(6):387-90.
We present results of treatment in 36 cases of distal tibial epiphyseolysis in 34 patients treated between 1999 and 2005 with a minimal follow up of 12 months (average 28,5, range 13-84 months). The mean age at injury was 12 years (range from 7 to 16). There were 22 cases of type II injury according to the Salter-Harris classification, 5 cases of type VII, 3 of type IV, 2 of type I and two cases of triplane fracture, one case of retrospectively recognised type V and one of type III. 12 children required open reduction and K-wire fixation, the rest of 22 children underwent closed reduction followed by percutaneus fixation in 12 cases. Concomitant fibular fracture occured in 30 cases and required open reduction and fixation in 4. There were 18 good, 14 fair and 3 bad results according to Gleizes. The mean AOFAS scale result was 92.7. One child underwent 2 weeks of intravenous antybiotic therapy to recover from superficial skin infection around percutaneus K-wires. Four cases of physeal bar formation were noted. In two of them distal tibial osteotomy to correct ankle varus was necessary and one underwent bony bridge removal followed by fatty tissue interposition. The remaining physeal bar resulted in 10 degree of ankle valgus without functional dispairement.
我们报告了1999年至2005年间治疗的34例患者中36例胫骨干骺端骨骺分离的治疗结果，最短随访12个月（平均28.5个月，范围13 - 84个月）。受伤时的平均年龄为12岁（范围7至16岁）。根据Salter-Harris分类，II型损伤22例，VII型5例，IV型3例，I型2例，双平面骨折2例，1例经回顾性诊断为V型，1例为III型。12名儿童需要切开复位和克氏针固定，其余22名儿童中，12例行闭合复位后经皮固定。30例伴有腓骨骨折，其中4例需要切开复位和固定。根据Gleizes标准，结果为优18例，良14例，差3例。AOFAS量表平均评分为92.7分。1名儿童因经皮克氏针周围浅表皮肤感染接受了2周的静脉抗生素治疗。发现4例骨桥形成。其中2例需要行胫骨干骺端截骨术以纠正踝内翻，1例接受了骨桥切除及脂肪组织植入术。其余骨桥导致10度的踝外翻，但无功能障碍。
