Fu G, Zhang J, Xu G, Lü X M, Yang Z
Department of Pediatric Orthopedics, Beijing Jishuitan Hospital, Beijing 100035, China.
Zhonghua Yi Xue Za Zhi. 2019 Jun 18;99(23):1792-1795. doi: 10.3760/cma.j.issn.0376-2491.2019.23.008.
To evaluate the effects of treatment of post-traumatic distal radius partial physeal arrest with physeal bar resection. From February 2007 to November 2017, 11 children with distal radius physeal arrest received physeal bar resection in the Department of Pediatric Orthopedics, Beijing Jishuitan Hospital. There were 2 females and 9 males. The average age of the patients was (10.1±1.8) years (range,7-13 years). All cases had previous history of distal radius trauma. The average duration from the previous fracture to the physeal bar resection operation was (22.8±3.2) months (range,22 to 41 months). Clinical and radiological evidence of distal radius physeal arrest were suggested in all patients. A CT or MRI scan was performed preoperatively to assess the size of the physeal bridge. Inclusion criteria were patients with a physeal bridge<30% of the physeal area,and with at least 2 years of growth remaining. The physeal bar resection operation was performed with the assistance of either fluoroscopy (5 cases) or intraoperative three dimensional navigation (6 cases). After resection, the void was then filled with bone wax in all cases and distal ulnar epiphysiodesis was conducted in 5 cases. The mean follow-up duration was (3.7±1.6) years (range,1-9 years). The clinical examination data and X ray were obtained during the follow up. Four cases obtained fully recovery from the operation and the deformity got fully correction. The X ray showed no bone bridge recurred. The deformity did not aggravate in 1 case. The deformity aggravated and subsequent osteotomy was conducted in the left 6 cases. Three cases in the navigation group obtained fully recovery. One case in the fluoroscopy group obtained fully recovery. The intraoperative three dimensional navigation can precisely locate the bone bridge. The physeal bar resection is an effective technique in some post-traumatic distal radius partial physeal arrest.
评估采用骨骺阻滞切除治疗创伤后桡骨远端部分骨骺阻滞的效果。2007年2月至2017年11月，11例桡骨远端骨骺阻滞患儿在北京积水潭医院小儿骨科接受了骨骺阻滞切除手术。其中女性2例，男性9例。患者的平均年龄为(10.1±1.8)岁（范围7 - 13岁）。所有病例既往均有桡骨远端创伤史。从既往骨折至骨骺阻滞切除手术的平均时间为(22.8±3.2)个月（范围22至41个月）。所有患者均有桡骨远端骨骺阻滞的临床和影像学证据。术前进行CT或MRI扫描以评估骨骺桥的大小。纳入标准为骨骺桥<骨骺面积的30%且剩余生长时间至少2年的患者。骨骺阻滞切除手术在透视辅助下进行5例，术中三维导航辅助下进行6例。切除后，所有病例均用骨蜡填充骨缺损处，5例进行了尺骨远端骨骺阻滞术。平均随访时间为(3.7±1.6)年（范围1 - 9年）。随访期间获取临床检查数据和X线片。4例手术完全恢复，畸形完全矫正。X线片显示无骨桥复发。1例畸形未加重。6例畸形加重，随后进行了截骨术。导航组3例完全恢复。透视组1例完全恢复。术中三维导航可精确定位骨桥。骨骺阻滞切除是治疗某些创伤后桡骨远端部分骨骺阻滞的有效技术。
