Walley Kempland C, Baumann Anthony N, Curtis Deven P, Mamdouhi Tania, Anastasio Albert T, Adams Samuel B
Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI, USA.
College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA.
Ann Jt. 2024 Apr 9;9:17. doi: 10.21037/aoj-23-51. eCollection 2024.
Arthroscopic-assisted treatment of ankle fractures has proven useful in the adult population, but little evidence exists for the utilization of arthroscopic-assisted ankle fracture fixation in the pediatric population. The purpose of this systematic review is to examine the management of pediatric ankle fractures using arthroscopy.
A systematic review was performed using PubMed, Web of Science, CINAHL, and MEDLINE from database inception to February 22, 2023. Inclusion criteria for this systematic review was pediatric population less than age 18, arthroscopic surgery management, and ankle fracture.
A total of 19 articles (n=30 patients) out of 176 articles met final inclusion criteria with all articles consisting of case reports or case series. The average patient age was 13.8±1.6 years. Sixteen of the patients (53%) had arthroscopic surgery along with an adjunct surgery as indicated, whereas 14 patients (47%) had arthroscopic surgery with or without percutaneous fixation. A high majority of patients demonstrated full range-of-motion and large improvements in function.
Arthroscopy is used with percutaneous fixation or in adjunct to open approaches for pediatric ankle fracture management with good results. More research is needed to determine the utility of arthroscopy in the management of pediatric ankle fractures.
关节镜辅助治疗成人踝关节骨折已被证明是有效的，但在儿童人群中使用关节镜辅助踝关节骨折固定的证据很少。本系统评价的目的是研究使用关节镜治疗儿童踝关节骨折的方法。
从数据库建立至2023年2月22日，使用PubMed、Web of Science、CINAHL和MEDLINE进行系统评价。本系统评价的纳入标准为年龄小于18岁的儿童人群、关节镜手术治疗和踝关节骨折。
176篇文章中共有19篇（n=30例患者）符合最终纳入标准，所有文章均为病例报告或病例系列。患者的平均年龄为13.8±1.6岁。16例患者（53%）根据需要进行了关节镜手术及辅助手术，而14例患者（47%）进行了关节镜手术，伴或不伴经皮固定。绝大多数患者表现出全关节活动范围，功能有显著改善。
关节镜与经皮固定联合使用或作为儿童踝关节骨折切开手术的辅助手段，效果良好。需要更多的研究来确定关节镜在儿童踝关节骨折治疗中的作用。
