儿童胫骨远端骨骺骨折后生长障碍的发生率。

Incidence of growth disturbance after distal tibia physeal fracture in children.

机构信息

Department of Pediatric Orthopedics, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350001, China.

Department of Pediatric Orthopedics, Fujian Children's Hospital, Fuzhou, 350011, China.

出版信息

J Orthop Surg Res. 2022 Dec 8;17(1):529. doi: 10.1186/s13018-022-03427-4.

DOI:10.1186/s13018-022-03427-4

PMID:36482401

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9730681/

Abstract

BACKGROUND

To analyze the growth disturbance after distal tibia physeal fracture in children.

METHODS

Data about children with distal tibia physeal fractures between September 2015 to September 2018 were collected, including age, gender, affected side, Salter-Harris classification, initial maximal displacement, with or without fibula fracture, open or closed reduction, the method of fixation, time to surgery, blood loss, duration of operation, and complications. Patients were placed in the growth disturbance group when leg length discrepancy was equal to or greater than 1.5 cm, or when they had more than 5 degrees of varus or valgus deformity. Others were placed in the no-growth disturbance group.

RESULTS

A total of 143 patients (96 boys and 47 girls) were enrolled in this study. The length of the follow-up periods averaged 29.34 ± 7.46 months (26 to 61 months). Among the total of 143 patients, the incidence of growth disturbance was 15.39% (22/143). The no-growth disturbance group consisted of 121 patients (84 boys and 37 girls), with a mean age of 11.50 ± 3.20 years, and there were 68, 52, and 1 injuries to the left, right, and bilateral sides, respectively. The average maximal displacement was 5.51 ± 3.18 mm, and 27.27% (33/121) of patients also had a fibula fracture. The growth disturbance group contained 22 patients (12 boys and 10 girls) with a mean age of 9.32 ± 3.56 years, and there were 12, 10, and 0 injuries on the left, right, and bilateral sides, respectively. The average maximal displacement was 5.77 ± 4.89 mm, and 45.45% (10/22) of patients also had a fibula fracture. There was a significant difference in age (p = 0.004) and fibula fracture (p = 0.011) between the two groups. More patients had Salter-Harris types III and IV fractures in the growth disturbance group than in the no-growth disturbance group (p = 0.043).

CONCLUSIONS

Children with Salter-Harris types III and IV fractures, younger children, and children with fibula fractures all have a higher incidence of growth disturbance after distal tibia physeal fractures.

LEVEL OF EVIDENCE

Level III-Prognostic study.

摘要

背景

分析儿童胫骨远端骺板骨折后的生长障碍。

方法

收集 2015 年 9 月至 2018 年 9 月间儿童胫骨远端骺板骨折的资料，包括年龄、性别、患侧、Salter-Harris 分类、初始最大移位、有无腓骨骨折、切开或闭合复位、固定方法、手术时间、失血量、手术时间和并发症。当肢体长度差异等于或大于 1.5cm 时，或出现大于 5 度内翻或外翻畸形时，患者被置于生长障碍组。无生长障碍的患者被置于无生长障碍组。

结果

本研究共纳入 143 例患者（96 例男性和 47 例女性）。平均随访时间为 29.34±7.46 个月（26 至 61 个月）。在总共 143 例患者中，生长障碍的发生率为 15.39%（22/143）。无生长障碍组 121 例（84 例男性和 37 例女性），平均年龄为 11.50±3.20 岁，左侧、右侧和双侧分别有 68、52 和 1 例损伤。最大移位平均为 5.51±3.18mm，27.27%（33/121）的患者同时伴有腓骨骨折。生长障碍组 22 例（12 例男性和 10 例女性），平均年龄为 9.32±3.56 岁，左侧、右侧和双侧分别有 12、10 和 0 例损伤。最大移位平均为 5.77±4.89mm，45.45%（10/22）的患者同时伴有腓骨骨折。两组间年龄（p=0.004）和腓骨骨折（p=0.011）有显著差异。生长障碍组的 Salter-Harris 类型 III 和 IV 骨折患者多于无生长障碍组（p=0.043）。