Schulze A, Schmittenbecher P P
Klinik für Kinderchirurgie, Städtisches Klinikum Karlsruhe, Moltkestr. 90, 76133, Karlsruhe, Deutschland.
Unfallchirurg. 2021 Jul;124(7):519-525. doi: 10.1007/s00113-021-01001-x. Epub 2021 May 3.
The importance of the apophyseal plates during growth is often underestimated. They act as a muscular insertion and influence the joint mechanics by the load-dependent change in shape.
An anatomically functional adaptation occurs as protection from overloading. In special kinds of sports with highly dynamic movements, sudden changes of direction and eccentric/concentric muscle activities the resulting stress may exceed the strength of the apophyseal plate. In adolescence this results in a total or partial tearing of the apophysis in the sense of an avulsion injury. In the pelvic region the ischial tuberosity, the anterior superior and inferior iliac spine are mainly affected.
The medical history and clinical diagnostics are supplemented by conventional radiographic imaging. Sectional imaging diagnostics are usually unnecessary.
Conservative management by reduced (partial) weight bearing and physiotherapy represents the gold standard in treatment. In cases with a fragment displacement >1.5-2.0 cm and in competitive athletes an open reduction should be considered.
生长过程中骺板的重要性常常被低估。它们作为肌肉附着点，并通过与负荷相关的形状变化影响关节力学。
作为对过载的保护，会发生解剖学上的功能适应。在具有高度动态运动、突然改变方向以及离心/向心肌肉活动的特殊运动类型中，所产生的应力可能超过骺板的强度。在青春期，这会导致骨骺出现完全或部分撕裂，类似于撕脱伤。在骨盆区域，坐骨结节、髂前上棘和髂前下棘是主要受影响部位。
病史和临床诊断需辅以传统的放射影像学检查。通常无需进行断层成像诊断。
通过减轻（部分）负重和物理治疗进行保守治疗是治疗的金标准。对于骨折块移位>1.5 - 2.0厘米的病例以及竞技运动员，应考虑进行切开复位。
