Ruffing T, Muhm M, Winkler H
Klinik für Unfall- und Wiederherstellungschirurgie, Westpfalz-Klinikum GmbH, Kaiserslautern, Deutschland.
Unfallchirurg. 2011 Aug;114(8):730-5. doi: 10.1007/s00113-011-1958-1.
Physiologic closure of the growth plate of the distal tibia occurs between the ages of 12 and 14 years in girls and 1 year later in boys. The closure of the tibial physis starts eccentrically at the ventrolateral zone of the medial malleolus extending dorsally and ends laterally. Therefore, the anterolateral zone is the last to ossify. The process of closure lasts about 18 months. During this period the growth plate loses its joint-protective function and transitional fractures may occur. The more the closure progresses the more lateral the location of the fracture. In addition to the typical transitional fractures, typical fracture patterns of adults in the ossified physis are possible due to a mature bone structure. We report two cases of transitional fractures combined with typical fracture patterns of adults due to a dorsomedial ossified physis in the distal tibia.
胫骨远端生长板的生理性闭合在女孩12至14岁之间发生，男孩则在1年后发生。胫骨骨骺的闭合从内踝的腹外侧区域开始偏心，向背侧延伸，最后在外侧结束。因此，前外侧区域是最后骨化的。闭合过程持续约18个月。在此期间，生长板失去其关节保护功能，可能会发生过渡性骨折。闭合进展得越多，骨折的位置就越靠外侧。除了典型的过渡性骨折外，由于骨结构成熟，在已骨化的骨骺中也可能出现成人典型的骨折模式。我们报告了两例因胫骨远端背内侧骨化骨骺导致的过渡性骨折合并成人典型骨折模式的病例。
