Valenza Weverley Rubele, Soni Jamil Faissal, Bodanese Bruno Henrique Schuta, Rossetto Deivide Mateus, Kosovits Francisco Guilherme DE Paula, Cordeiro Pedro Ivo Pedroni
. Hospital do Trabalhador de Curitiba, Curitiba, PR, Brazil.
. Hospital Universitário Evangélico Mackenzie, Curitiba, PR, Brazil.
Acta Ortop Bras. 2023 Jun 9;31(spe2):e262167. doi: 10.1590/1413-785220233102e262167. eCollection 2023.
Distal femoral metaphyseal fractures are rare in children, and the proximity of the fracture to the growth plate makes their approach challenging.
Evaluate outcomes and complications of treatment of distal femoral metaphyseal fractures in children with proximal humeral locking plates.
Retrospective study between 2018 and 2021, including seven patients. The analysis included general characteristics, trauma mechanism, classification, clinical and radiographic outcomes, and complications.
The mean follow-up was 20 months, the average age was nine years, five patients were boys, and six fractured on the right side. Five fractures were caused by car accidents, one by falling from their own height and one by playing soccer. Five fractures were classified as 33-M/3.2 and two as 33-M/3.1. Three fractures were open, Gustilo IIIA. All seven patients recovered mobility and resumed their pre-trauma activities. All seven healed, and one fracture was reduced to 5 degrees valgus, without any other complications. Six patients had the implant removed and did not present refracture.
Treatment of distal femoral metaphyseal fractures with proximal humeral locking plates is a viable option that offers good results and fewer complications, saving the epiphyseal cartilage. Level of Evidence II; Controlled study without randomization.
儿童股骨远端干骺端骨折较为罕见,且骨折部位靠近生长板,这使得其治疗颇具挑战性。
评估使用肱骨近端锁定钢板治疗儿童股骨远端干骺端骨折的疗效及并发症。
对2018年至2021年间的7例患者进行回顾性研究。分析内容包括一般特征、创伤机制、分类、临床及影像学结果以及并发症。
平均随访20个月,平均年龄9岁,5例为男性,6例右侧骨折。5例骨折由车祸所致,1例因从自身高度跌落,1例因踢足球。5例骨折分类为33-M/3.2,2例为33-M/3.1。3例骨折为开放性,Gustilo IIIA 型。所有7例患者均恢复了活动能力并恢复了伤前活动。全部7例均愈合,1例骨折出现5°外翻,无其他并发症。6例患者取出内固定物后未出现再骨折。
使用肱骨近端锁定钢板治疗儿童股骨远端干骺端骨折是一种可行的选择,疗效良好且并发症较少,可保留骨骺软骨。证据等级II;非随机对照研究。