Pfeil J, Fromm B, Carstens C, Cotta H
Orthopädischen Universitätsklinik, Heidelberg.
Z Orthop Ihre Grenzgeb. 1990 Nov-Dec;128(6):551-8. doi: 10.1055/s-2008-1040003.
Between February 1971 and February 1988, 947 children with myelomeningocele were treated at the Model Center of Heidelberg University Orthopedic Clinic. In 82 of these children, a total of 224 osseous lesions were seen. Metaphyseal and diaphyseal fractures were far more common than epiphyseal lesions, among which epiphysiolysis dominated. Diagnostically important symptoms included swelling, local hyperthermia, and high temperature. Owing to the paralysis, pain is of no value in diagnosing fractures. Protruding periosteal detachments are a common feature of lesions, and if this special form of healing of such fractures is unknown they may cause problems in differential diagnosis. Fractures in children with spina bifida should be treated conservatively, except for fractures of the femoral neck and epiphyseal lesions, which are treated with transcutaneous Kirschner wiring. Immobilization in plaster, postoperatively and during treatment of the injury, is the most common cause of osseous lesions in spina bifida children. Immobilization in plaster should therefore be minimized.
1971年2月至1988年2月期间，海德堡大学骨科诊所示范中心对947例脊髓脊膜膨出患儿进行了治疗。在其中82例患儿中，共发现224处骨病变。干骺端和骨干骨折远比骨骺病变常见，其中骨骺分离占主导。具有诊断意义的症状包括肿胀、局部发热和体温升高。由于存在瘫痪情况，疼痛对骨折诊断没有价值。骨膜剥离突出是病变的常见特征，如果不了解这种特殊形式的骨折愈合情况，可能会在鉴别诊断中造成问题。除股骨颈骨折和骨骺病变采用经皮克氏针内固定治疗外，脊柱裂患儿的骨折应采用保守治疗。石膏固定，无论是在术后还是在损伤治疗期间，都是脊柱裂患儿骨病变最常见的原因。因此，应尽量减少石膏固定。
