Ruffing T, Muhm M, Winkler H
Klinik für Unfall- und Wiederherstellungschirurgie, Westpfalz-Klinikum GmbH, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Deutschland.
Unfallchirurg. 2010 Jun;113(6):495-500. doi: 10.1007/s00113-009-1725-8.
Cuboid fractures in children are rare. Missed fractures of the cuboid may lead to severe alterations in foot mechanics and function. In the case described a 9-year-old girl suffered a compression fracture of the cuboid after falling from a tree. The rarity of this injury in children results in a lack of standardized procedures. If severe impaction is present bone grafting is recommended. Transarticular K-wires are usually used for transfixation of the calcaneocuboid joint after open reduction. Disadvantages are damage to the cartilage caused by transarticular transfixation and potential loss of anatomical reduction of the cuboid. Considering operative treatment in adults, we used a fixed-angle plate for internal fixation after open reduction to reduce these risks. Bone grafting was not necessary. Due to continuing growth the plate was removed 6 months after the operation. Physical and radiological examinations revealed an excellent result.
儿童骰骨骨折较为罕见。骰骨骨折漏诊可能会导致足部力学和功能严重改变。在所述病例中，一名9岁女孩从树上跌落，导致骰骨压缩性骨折。这种损伤在儿童中罕见，导致缺乏标准化的治疗程序。如果存在严重嵌插，建议进行植骨。切开复位后，通常使用经关节克氏针固定跟骰关节。缺点是经关节固定会损伤软骨，且骰骨可能会失去解剖复位。考虑到成人的手术治疗，我们在切开复位后使用了角钢板内固定以降低这些风险。无需植骨。由于患儿仍在生长，术后6个月取出了钢板。体格检查和影像学检查结果均显示良好。
