摘要
目的比较两种切开复位内固定治疗青少年胫骨远端前外侧骨骺骨折(Tillaux骨折)的疗效。方法采用切开复位内固定治疗32例青少年Tillaux骨折患者,按照内固定方式不同分为空心螺钉组(20例)和克氏针组(12例)。记录手术时间、骨折愈合时间、术后并发症发生情况。采用AOFAS踝-后足评分评价患肢关节功能。结果患者均获得随访,空心螺钉组随访时间12~60(28.55±14.89)个月,克氏针组随访时间16~56(26.17±11.00)个月。两组切口均甲级愈合,术后均无感染、血管神经损伤、骨骺早闭、关节畸形及踝关节功能障碍等并发症发生。手术时间、骨折愈合时间及末次随访时AOFAS踝-后足评分两组比较差异均无统计学意义(P> 0.05)。末次随访时两组患侧踝关节均可正常负重活动,踝关节活动度均恢复至正常范围。结论切开复位空心螺钉和克氏针内固定均为治疗青少年Tillaux骨折的安全、有效方法。
Objective To compare the clinical efficacy of two kinds of open reduction and internal fixation in the treatment of the isolated fracture of the anterolateral distal tibial epiphysis( Tillaux fracture) in the adolescent. Methods The 32 cases of the Tillaux fracture were treated by open reduction and internal fixation. According to different internal fixation methods,they were divided into cannulated screw group( 20 cases) and Kirschner wire group( 12 cases). The operation time,healing time of fracture,postoperative complications were recorded,and AOFAS ankle-hindfoot score was used to evaluate the joint function of the affected limb. Results All patients were followed up,the follow-up time was 12 ~ 60( 28. 55 ± 14. 89) months in the cannulated screw group and 16 ~ 56( 26. 17 ± 11. 00)months in the Kirschner group. All incisions got primary healing. There was no complications such as infection,neurovascular injury,physeal early arrest,joint deformities or ankle joint dysfunctions. There were no significant differences in the operation time,fracture healing time and AOFAS ankle-hindfoot score at the last follow-up between the two groups( P > 0. 05). All involved ankle joints were restored to normal weight bearing and range of motion at the final follow-up. Conclusions Both open reduction and internal fixation with cannulated screw or Kirschner wire methods are the safe and effective techniques in the treatment of the Tillaux fracture in children.
作者
姜宇
郭源
杨征
吕学敏
尤海峰
杨豪
JIANG Yu;GUO Yuan;YANG Zheng;Lü Xue-min;YOU Hai-feng;YANG Hao(Dept of Pediatric Orthopaedics,Beijing Jishuitan Hospital,the Forth Clinical Medical College of Peking University,Beijing 100035,China)
出处
《临床骨科杂志》
2021年第4期584-587,共4页
Journal of Clinical Orthopaedics
基金
北京市卫健委优秀人才培养青年骨干个人项目(编号:2018000021469G226)。
