Khouri N, Ducloyer P, Carlioz H
Service de Chirurgie orthopédique et réparatrice de l'enfant, Hôpital Trousseau, Paris.
Rev Chir Orthop Reparatrice Appar Mot. 1989;75(6):394-404.
The authors report their experience with a series of 25 distal tibial triplane fractures: 13 two-fragment lateral triplane fractures, 10 three-fragment lateral triplane fractures and 2 medial triplane fractures. These cases were mostly adolescents near the end of the growth spurt period. Tomography or CT scanning allowed a better delineation of the anatomic type of the fracture and of the displacements. Treatment modalities, surgical versus conservative are presented. Therapeutic indications depended on the anatomic configuration of the fracture; closed methods were most often applied to the two-fragment lateral triplane fractures, surgical treatment for most of the three-fragment lateral triplane fractures and for the medial triplane fractures. Results were usually good after an intermediate term follow-up. Joint incongruity secondary to insufficient reduction was a more severe sequela than growth disturbances.
作者报告了他们对一系列25例胫骨干骺端三平面骨折的治疗经验:13例两部分型外侧三平面骨折,10例三部分型外侧三平面骨折和2例内侧三平面骨折。这些病例大多是接近生长高峰期结束的青少年。体层摄影或CT扫描能更好地描绘骨折的解剖类型和移位情况。文中介绍了手术与保守两种治疗方式。治疗指征取决于骨折的解剖结构;闭合方法最常用于两部分型外侧三平面骨折,大多数三部分型外侧三平面骨折和内侧三平面骨折则采用手术治疗。中期随访后结果通常良好。复位不足导致的关节不匹配是比生长紊乱更严重的后遗症。