Taşkıran Mustafa Can, Turgut Ali, Kalenderer Onder, Ağuş Haluk
Department of Orthopedics and Traumatology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey.
Ulus Travma Acil Cerrahi Derg. 2012 Nov;18(6):495-500. doi: 10.5505/tjtes.2012.46548.
In this study, we evaluated the clinical and radiological results of the distal tibial epiphyseal fractures in children treated with surgery.
We evaluated 59 patients (33 boys, 26 girls) retrospectively. Physeal fractures were classified according to the Salter-Harris classification: 4 fractures were type I, 22 type II, 29 type III, and the remaining 4 type IV. Closed reduction and internal fixation were performed in 29 patients, while open reduction and internal fixation were performed in 30 patients. Mean age at the time of trauma was 10.9 years (6-14). Patients were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) score.
Patients were operated in a mean of 3.8 hours (3-72). Fixation was performed with Kirschner (K)-wire in 50 patients, with screw in 6 patients, and with both K-wire and screw in 3 patients. Mean follow-up time was 71.7 months (12-149). Due to premature physeal arrest, 1 cm shortening and valgus deformity were seen in only one patient. However, no infection, nonunion, or osteonecrosis was observed in any patient. Mean AOFAS score was 86.6 (65-100) at the last follow-up.
Successful results with fewer complications could be obtained in ankle physeal fractures with early management through adequate reduction and stabilized fixation.
在本研究中，我们评估了接受手术治疗的儿童胫骨干骺端骨折的临床和影像学结果。
我们回顾性评估了59例患者（33例男孩，26例女孩）。根据Salter-Harris分类法对骨骺骨折进行分类：4例为I型骨折，22例为II型骨折，29例为III型骨折，其余4例为IV型骨折。29例患者进行了闭合复位内固定，30例患者进行了切开复位内固定。受伤时的平均年龄为10.9岁（6 - 14岁）。采用美国矫形足踝协会（AOFAS）评分对患者进行评估。
患者平均在3.8小时（3 - 72小时）内接受手术。50例患者采用克氏针固定，6例患者采用螺钉固定，3例患者采用克氏针和螺钉联合固定。平均随访时间为71.7个月（12 - 149个月）。仅1例患者因骨骺过早停止生长出现1厘米短缩和外翻畸形。然而，所有患者均未观察到感染、骨不连或骨坏死。末次随访时平均AOFAS评分为86.6（65 - 100）。
通过充分复位和稳定固定进行早期处理，踝关节骨骺骨折可获得并发症较少的成功结果。
