Prabhakar Gautham, Kusnezov Nicholas, Eisenstein Emmanuel, Dunn John C, Abdelgawad Amr
Department of Orthopaedic Surgery, UT Health San Antonio, San Antonio, TX, USA.
Department of Orthopaedic Surgery and Rehabilitation, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA.
Case Rep Orthop. 2020 Aug 7;2020:8889066. doi: 10.1155/2020/8889066. eCollection 2020.
Pediatric tibial nonunion following corrective osteotomy is a rare complication that is not well understood. While adult nonunions have been linked to endocrine and metabolic aberrations, this has not been established in a pediatric population. Pediatric tibial nonunion has been shown to respond to debridement with revision fixation using dynamic compression plating, supplementary bone graft, and fibular osteotomy to allow compression. Necessity of referral for metabolic and endocrinology workup remains unclear in the pediatric population, though inflammatory markers should be obtained in each case to rule out infection. We present three consecutive cases of pediatric tibial nonunion following osteotomy over a five-year period and discuss the management.
儿童截骨矫形术后胫骨骨不连是一种罕见的并发症，目前对此了解尚少。虽然成人骨不连与内分泌和代谢异常有关，但在儿童人群中尚未得到证实。已有研究表明，儿童胫骨骨不连采用动力加压钢板翻修固定、补充植骨以及腓骨截骨以实现加压的清创术治疗有效。尽管在每例病例中都应检测炎症指标以排除感染，但在儿童人群中，转诊至代谢和内分泌科进行检查的必要性仍不明确。我们报告了5年内连续3例儿童截骨术后胫骨骨不连的病例，并讨论了其治疗方法。
