Hill Brian W, Rizkala Amir R, Li Mengnai
Department of Orthopaedic Surgery, Regions Hospital, University of Minnesota, St Paul, Minnesota, USA.
J Pediatr Orthop B. 2014 Sep;23(5):411-8. doi: 10.1097/BPB.0000000000000072.
Pediatric proximal tibial epiphysis fractures are uncommon and have subsequently received little attention in terms of treatment and outcomes. We studied the clinical and functional outcomes of 13 patients with Salter-Harris III and IV fractures of the proximal tibial epiphysis after operative fixation. Associated meniscus, ligamentous, or neurovascular injury was present in 100% of this cohort. Provisional external fixation and locked plating spanning the open physis were used in the majority of cases. The mean clinical follow-up was 15.69 months, where all fractures progressed to union. Good functional outcomes with a low complication rate are possible after operative fixation of these infrequent injuries.
小儿胫骨近端骨骺骨折并不常见，因此在治疗和预后方面很少受到关注。我们研究了13例接受手术固定的胫骨近端骨骺Salter-Harris III型和IV型骨折患者的临床和功能预后。该队列中100%的患者存在相关的半月板、韧带或神经血管损伤。大多数病例采用临时外固定和跨越开放骨骺的锁定钢板固定。平均临床随访时间为15.69个月，所有骨折均愈合。对于这些罕见损伤，手术固定后可能获得良好的功能预后且并发症发生率较低。
