Ye Cong-cong, Zha You-ming, Guo Wei-jun, Yang Xiang
Zhongguo Gu Shang. 2014 Aug;27(8):691-3.
To study the therapeutic efficacy of manipulative reduction and percutaneous pin fixation for the treatment of severely displaced distal tibial fractures in children.
From May 2009 to December 2012,56 children with severely displaced distal tibial fractures were analyzed, who had been treated with manipulative reduction and percutaneous pin fixation. Preoperative fractures were confirmed as severely displaced fractures by X-ray apparatus. There were 33 boys and 23 girls,ranging in age from 3 to 14 years, with an average of 10.1 years. All the fractures were closed without vascular or nerve injuries. According to the bone fracture type, under C-arm fluoroscopy, functional reduction was achieved by manipulative reduction. The fractures were fixed with percutaneous pins. Postoperative X-ray confirmed the functional reduction. Follow-up indexes were recorded: intra-operative and postoperative complications,postoperative radiographic examination, lower extremity length and range of ankle motion. Ankle score system of Teeny was used to evaluate ankle function.
All the patients were followed up, and the duration ranged from 3 to 46 months, with an average duration of 19.4 months. According to the Teeny score standard, 35 patients got an excellent result, 7 good and 3 fair. Pin track reaction was found in 4 cases. The X-ray showed all the fractures healed without shortening deformity or epiphyseal arrest at early stage. All the patients could participate in the normal physical activities, having a normal range of motion and excellent strength of the ankle joint.
The method of manipulative reduction and percutaneous pin fixation is a safe and convenient treatment for severely displaced distal tibial fractures in children. It has several advantages as follow: micro-trauma, tiny tissue damage, firm fixation, and the patients can exercise the function of ankle early, suggesting that it is an effective treatment method.
探讨手法复位经皮克氏针内固定治疗儿童严重移位的胫骨远端骨折的疗效。
分析2009年5月至2012年12月采用手法复位经皮克氏针内固定治疗的56例儿童严重移位的胫骨远端骨折患者。术前经X线检查确诊为严重移位骨折。其中男33例，女23例，年龄3～14岁，平均10.1岁。所有骨折均为闭合性，无血管或神经损伤。根据骨折类型，在C型臂透视下，通过手法复位达到功能复位，经皮克氏针固定。术后X线证实功能复位。记录随访指标：术中及术后并发症、术后影像学检查、下肢长度及踝关节活动度。采用Teeny踝关节评分系统评价踝关节功能。
所有患者均获随访，随访时间3～46个月，平均19.4个月。按照Teeny评分标准，优35例，良7例，可3例。4例出现针道反应。X线显示所有骨折均早期愈合，无短缩畸形或骨骺阻滞。所有患者均能参加正常体育活动，踝关节活动度正常，力量良好。
手法复位经皮克氏针内固定治疗儿童严重移位的胫骨远端骨折安全、方便，具有创伤小、组织损伤轻、固定可靠、患者可早期进行踝关节功能锻炼等优点，是一种有效的治疗方法。
