Messner J, Johnson L, Taylor D M, Harwood P, Britten S, Foster P
Leeds Major Trauma Centre and Limb Reconstruction Unit, Leeds Children's Hospital at Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK.
Bone Joint J. 2018 Mar 1;100-B(3):396-403. doi: 10.1302/0301-620X.100B3.BJJ-2017-0863.R1.
The aim of this study was to report the clinical, functional and radiological outcomes of children and adolescents with tibial fractures treated using the Ilizarov method.
Between 2013 and 2016 a total of 74 children with 75 tibial fractures underwent treatment at our major trauma centre using an Ilizarov frame. Demographic and clinical information from a prospective database was supplemented by routine functional and psychological assessment and a retrospective review of the notes and radiographs.
Of the 75 fractures, 26 (35%) were open injuries, of which six (8%) had segmental bone loss. There were associated physeal injuries in 18 (24%), and 12 (16%) involved conversion of treatment following failure of previous management. The remaining children had a closed unstable fracture or significant soft-tissue compromise. The median follow-up was 16 months (7 to 31). All fractures united with a median duration in a frame of 3.6 months (interquartile range 3.1 to 4.6); there was no significant difference between the types of fracture and the demographics of the patients. There were no serious complications and no secondary procedures were required to achieve union. Health-related quality of life measures were available for 60 patients (80%) at a minimum of six months after removal of the frame. These indicated a good return to function (median Paediatric quality of life score, 88.0; interquartile range 70.3 to 100).
The Ilizarov method is a safe, effective and reliable method for the treatment of complex paediatric tibial fractures. Cite this article: Bone Joint J 2018;100-B:396-403.
本研究旨在报告采用伊里扎洛夫方法治疗儿童和青少年胫骨骨折的临床、功能及影像学结果。
2013年至2016年期间，共有74例儿童的75处胫骨骨折在我们的主要创伤中心接受了伊里扎洛夫外固定架治疗。前瞻性数据库中的人口统计学和临床信息，通过常规功能及心理评估以及对病历和X光片的回顾性分析进行补充。
在75处骨折中，26处（35%）为开放性损伤，其中6处（8%）存在节段性骨缺损。18处（24%）伴有骨骺损伤，12处（16%）涉及先前治疗失败后的治疗转换。其余儿童为闭合性不稳定骨折或严重软组织损伤。中位随访时间为16个月（7至31个月）。所有骨折均愈合，外固定架固定的中位时长为3.6个月（四分位间距3.1至4.6个月）；骨折类型与患者人口统计学特征之间无显著差异。无严重并发症，无需二次手术来实现骨折愈合。60例患者（80%）在拆除外固定架后至少6个月时可获得与健康相关的生活质量测量数据。这些数据表明功能恢复良好（儿童生活质量评分中位数为88.0；四分位间距70.3至100）。
伊里扎洛夫方法是治疗儿童复杂胫骨骨折的一种安全、有效且可靠的方法。引用本文：《骨与关节杂志》2018年；100 - B：396 - 403。
