Ogden J A, Ogden D A, Pugh L, Raney E M, Guidera K J
Georgia Baptist Medical Center, Department of Medical Education, Atlanta 30214, USA.
J Pediatr Orthop. 1995 Jul-Aug;15(4):489-94. doi: 10.1097/01241398-199507000-00016.
Seventeen children with 19 proximal tibial metaphyseal fractures were followed-up between 2 and 7 years after injury. Detailed measurements of the metaphyseal/diaphyseal/metaphyseal distances medially and laterally on the injured and noninjured sides demonstrated overgrowth. In four patients, the medial distance of the injured tibia was longer than the lateral distance, which was the same distance as the uninjured tibia. In 11 patients, there was an overgrowth of both the medial and lateral sides of the injured tibia, compared to the unijured tibia, and in each instance, the medial distance of the injured tibia was always longer than the lateral. In a patient with bilateral metaphyseal fractures, the medial length exceeded the lateral length in both tibias. In the child with metaphyseal and diaphyseal fractures, the medial side of the tibia with the metaphyseal fracture was the longest of the four measurements. In five of six patients with Harris lines, there was distal as well as proximal tibial metaphyseal overgrowth, but the distal line was always parallel to the physis and did not contribute to the valgus angulation. Thus there was not only a generalized increased growth proximally and distally, but there also was an eccentric proximal medial overgrowth in every patient.
17名患有19处胫骨近端干骺端骨折的儿童在受伤后2至7年接受了随访。对受伤侧和未受伤侧的干骺端/骨干/干骺端内侧和外侧距离进行详细测量，结果显示有过度生长。在4例患者中，受伤胫骨的内侧距离比外侧距离长，而外侧距离与未受伤胫骨相同。在11例患者中，与未受伤胫骨相比，受伤胫骨的内侧和外侧均有过度生长，并且在每种情况下，受伤胫骨的内侧距离总是比外侧长。在一名双侧干骺端骨折的患者中，双侧胫骨的内侧长度均超过外侧长度。在患有干骺端和骨干骨折的儿童中，发生干骺端骨折的胫骨内侧是四项测量中最长的。在6例有哈里斯线的患者中，有5例胫骨近端和远端干骺端均有过度生长，但远端线始终与骺板平行，且不导致外翻成角。因此，不仅近端和远端普遍生长增加，而且每名患者近端内侧均有偏心性过度生长。
