小儿骨软骨骨折：临床研究表明，关节镜检查可早期诊断、早期康复。
Pediatric osteochondral fractures: clinical insights associate early diagnosis to early rehabilitation via arthroscopy.
机构信息
1st Department of Orthopaedics, P. & A. Kyriakou Children's Hospital, Athens, Greece.
Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, 115 27, Athens, Greece.
出版信息
Eur J Orthop Surg Traumatol. 2024 Apr;34(3):1657-1665. doi: 10.1007/s00590-024-03852-7. Epub 2024 Feb 20.
PURPOSE
This retrospective observational cohort analysis aims to address diagnostic and therapeutic challenges in managing osteochondral fractures (OCFs) resulting from acute patella dislocation and ankle sprains in children.
METHODS
The study includes 15 children treated for OCFs between January 2020 and July 2022. Data were obtained from medical records and analyzed using logistic regression.
RESULTS
The diagnostic and treatment algorithm involves detailed history, clinical examination, and imaging, with MRI guiding therapeutic decisions. Arthroscopic or mini open fixation led to successful rehabilitation, with 93% achieving full mobility at 9 months. Age was identified as a slight risk factor for free fragments in MRI, and arthroscopic management correlated with faster recovery at 3 months.
CONCLUSION
This study underscores the importance of immediate diagnosis and minimally invasive intervention for OCFs in children. Timely treatment, guided by a diagnostic algorithm, facilitates joint restoration and prevents degenerative consequences, ensuring a return to regular activities within a year postoperatively.
LEVEL OF EVIDENCE
IV.
目的
本回顾性观察队列分析旨在解决儿童急性髌骨脱位和踝关节扭伤所致骨软骨骨折（OCF）的诊断和治疗挑战。
方法
本研究纳入了 2020 年 1 月至 2022 年 7 月期间收治的 15 例 OCF 患儿。数据来自病历，并使用逻辑回归进行分析。
结果
诊断和治疗方案包括详细的病史、临床检查和影像学检查，MRI 指导治疗决策。关节镜或微创固定可实现成功康复，93%的患者在 9 个月时可实现完全活动度。年龄是 MRI 中游离碎片的轻微危险因素，关节镜治疗与 3 个月时的更快恢复相关。
结论
本研究强调了儿童 OCF 立即诊断和微创干预的重要性。及时治疗，采用诊断算法，有助于关节恢复，防止退行性后果，术后一年内可恢复正常活动。
证据水平
IV 级。
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