Pappas A M, Anas P, Toczylowski H M
J Bone Joint Surg Am. 1984 Apr;66(4):575-81.
We are reporting six cases of premature asymmetrical closure of the proximal tibial physis and associated genu recurvatum deformity and have reviewed the fourteen cases reported in the English-language literature. No single etiological factor could be implicated as the cause of the physeal arrest. Trauma, prolonged immobilization, tibial wire traction, and a surgical procedure involving the proximal tibial physis were observed risk factors among our patients. In our patients, established genu recurvatum due to deformity of the proximal end of the tibia and associated tibial length discrepancy were managed successfully by an opening-wedge osteotomy through the proximal one-third of the tibia and bone-grafting. Epiphyseodesis in the contralateral extremity may be required in patients with significant shortening of the tibia.
我们报告了6例胫骨近端骨骺过早不对称闭合及相关的膝反屈畸形病例,并回顾了英文文献中报道的14例病例。没有单一的病因可被认为是骨骺阻滞的原因。在我们的患者中,观察到的危险因素包括创伤、长期固定、胫骨钢丝牵引以及涉及胫骨近端骨骺的手术。在我们的患者中,由于胫骨近端畸形和相关的胫骨长度差异导致的已确立的膝反屈,通过胫骨近端三分之一处的开放楔形截骨术和植骨术成功得到处理。对于胫骨明显缩短的患者,可能需要对侧肢体进行骨骺阻滞术。