Poell J, Lehner M
Helv Chir Acta. 1977 Mar;44(1-2):211-7.
66 children who were admitted to the Surgical Department of the University Children's Hospital in Zurich because of transverse fracture of the distal tibia and fibula were followed up. They were treated conservatively by reduction followed by immobilization in a plaster of Paris cast reaching to the upper thigh; the foot was placed in the equinus position. Perfect axial reposition should be aimed at. If this cannot be achieved, a varus deformity of up to 6 degrees, a valgus deformity of up to 10 degrees and antecurvation of up to 10 degrees are permissible, as this malposition usually cures itself in time. If the malformation exceeds the limits described above, operative reduction and fixation should be carried out in children over 12 years of age. All children with malposition must be followed up for a long time to observe whether the malposition will gradually disappear and to ascertain whether static difficulties will occur and may have to be corrected by osteotomy.
对因胫腓骨远端横行骨折而入住苏黎世大学儿童医院外科的66名儿童进行了随访。他们接受了保守治疗,先进行复位,然后用石膏固定至大腿上部;足部置于马蹄足位。应争取实现完美的轴向复位。如果无法实现,允许有高达6度的内翻畸形、高达10度的外翻畸形和高达10度的前凸畸形,因为这种错位通常会随着时间自行纠正。如果畸形超过上述限度,12岁以上的儿童应进行手术复位和固定。所有有错位的儿童都必须长期随访,观察错位是否会逐渐消失,并确定是否会出现静态困难,是否可能需要通过截骨术进行纠正。