Pennsylvania State University College of Medicine, Department of Orthopaedics, Hershey, Pennsylvania.
J Surg Orthop Adv. 2020 Winter;29(4):219-224.
Current literature suggests that distal tibia Salter-Harris Type III and IV fractures with > 2 mm of displacement should be treated surgically to minimize growth arrest. The objective of the current study is to determine, in Salter-Harris Type III and IV distal tibia fractures, if gap displacements < 2 mm post-surgery are associated with fracture union, if step-offs > 2 mm post-surgery are associated with osteoarthritis, and to determine how often growth disturbances are observed in surgically-treated patients. A retrospective case series review of fourteen patients with displaced distal tibia Salter-Harris Type III and IV fractures was performed. The patients were evaluated using Kärrholm's method of clinical evaluation. The current study demonstrated that surgical reduction to < 2 mm gap displacement results in fracture union in all cases, reduction to < 2 mm does not result in osteoarthritis in any cases, and only 8% of patients demonstrated a growth disturbance with surgical intervention. (Journal of Surgical Orthopaedic Advances 29(4):219-224, 2020).
目前的文献表明，对于>2mm 移位的胫骨远端 Salter-Harris III 型和 IV 型骨折，应进行手术治疗以尽量减少生长停滞。本研究的目的是确定在 Salter-Harris III 型和 IV 型胫骨远端骨折中，手术后间隙<2mm 是否与骨折愈合相关，手术后台阶>2mm 是否与骨关节炎相关，并确定在手术治疗的患者中观察到生长障碍的频率。对 14 例有移位的胫骨远端 Salter-Harris III 型和 IV 型骨折患者进行了回顾性病例系列研究。采用 Kärrholm 的临床评估方法对患者进行评估。本研究表明，手术复位至<2mm 间隙可使所有病例的骨折愈合，<2mm 复位不会导致任何病例的骨关节炎，只有 8%的患者在手术干预后出现生长障碍。（《手术骨科进展杂志》29(4):219-224，2020 年）。
