Pesl Tomas, Havranek Petr
Department of Pediatric and Trauma Surgery, 3rd Faculty of Medicine, Charles University, Thomayer Teaching Hospital, Prague, Czech Republic,
J Child Orthop. 2008 Oct;2(5):353-6. doi: 10.1007/s11832-008-0126-9. Epub 2008 Sep 6.
Acute tibial tubercle avulsion fractures typically occur in adolescent boys involved in certain sports. All of the excerpted authors recommend open reduction and internal fixation (ORIF) as the only method to manage the displaced form of the injury. We attempted to select the optimal medical treatment of various types of this injury. The closed reduction and internal fixation (CRIF) method was selectively used.
During a period of 10 years (1997-2006), we treated 12 children with an acute injury to the tibial tubercle. Ogden's classification was used to describe the type of injury. Nine patients with a displaced fracture were treated surgically, using either the CRIF or ORIF methods. In cases of intraarticular fracture, the use of the CRIF method was tested. The suitability of the CRIF method was decided during manipulation of the fragments under an X-ray amplifier.
According to Ogden's classification, three children were classified with type 1A, one with 1B, three with 2A, four with 3A, and one with 3B. In patients with the displaced extraarticular injury (types 1B and 2A), the ORIF method of treatment was necessary. In all but one case of intraarticular fracture (type 3A and 3B), the CRIF method was sufficient.
The authors recommend that, for displaced intraarticular Ogden's type 3A or 3B fracture, the CRIF method should be considered as a first choice.
急性胫骨结节撕脱骨折通常发生在参与某些运动的青春期男孩中。所有摘录的作者都推荐切开复位内固定（ORIF）作为处理该损伤移位形式的唯一方法。我们试图选择针对该损伤各种类型的最佳治疗方法。选择性地使用了闭合复位内固定（CRIF）方法。
在10年期间（1997 - 2006年），我们治疗了12例胫骨结节急性损伤的儿童。采用奥格登分类法描述损伤类型。9例移位骨折患者采用CRIF或ORIF方法进行手术治疗。对于关节内骨折病例，测试了CRIF方法的适用性。在X线影像增强器下对骨折块进行手法操作时确定CRIF方法的适用性。
根据奥格登分类法，3例患儿为1A型，1例为1B型，3例为2A型，4例为3A型，1例为3B型。对于移位的关节外损伤（1B型和2A型）患者，需要采用ORIF治疗方法。除1例关节内骨折（3A型和3B型）外，所有病例采用CRIF方法均足够。
作者建议，对于移位的关节内奥格登3A型或3B型骨折，应首先考虑CRIF方法。
