摘要
[目的]探讨空心螺钉内固定治疗儿童胫骨远端骨骺骨折的临床疗效。[方法]回顾性分析2018年12月—2021年12月采用闭合或切开复位后空心螺钉内固定儿童胫骨远端骨骺骨折70例患者的临床资料,评价临床及影像效果。[结果] 70例患者均顺利完成手术治疗,术中未出现血管、神经损伤等并发症。平均随访时间(8.4±2.1)个月,与术前相比,术后3个月和末次随访时VAS评分均显著下降[(5.9±1.0)分,(1.3±0.3)分,(1.2±0.2)分,P<0.001],而AOFAS评分[(34.8±7.9)分,(82.7±8.9)分,(94.1±4.1)分, P<0.001]、踝关节背伸-跖屈ROM [(36.5±4.3)°,(63.8±10.4)°,(74.9±11.5)°, P<0.001]和内翻-外翻ROM [(30.7±6.9)°,(54.8±8.9)°,(65.8±9.0)°, P<0.001]。影像方面,与术前相比,术后骨折力线对合显著改善(P<0.05),mLDTA角和a ADTA角显著增加(P<0.05)。所有患者骨折均在10周左右骨性愈合。[结论]空心螺钉内固定治疗儿童胫骨远端骨骺骨折近期效果满意,是较为可靠的治疗手段。
[Objective] To investigate the clinical outcomes of cannulated screw fixation of distal tibial epiphysis fracture in children.[Methods] A retrospective study was performed on 70 children who had distal tibial epiphysis fractures fixed with cannulated screws following closed or open reduction from December 2018 to December 2021, and the clinical and imaging data were evaluated. [Results] All the70 patients were operated on successfully without complications such as vascular and nerve injury during the operation. The follow-up period lasted for(8.4±2.1) months on an average. Compared with those before operation, and the VAS score at 3 months and the last time significantly decreased [(5.9±1.0),(1.3±0.3),(1.2±0.2), P<0.001], while AOFAS score [(34.8 ±7.92),(82.7±8.9),(94.1±4.1), P<0.001], ankle dorsal-plantar flexion range of motion(ROM) [(36.5±4.3)°,(63.8±10.4)°,(74.9±11.5)°, P<0.001] and inversion-eversion ROM [(30.7±6.9)°,(54.8±8.9)°,(65.8±9.0)°, P<0.001] significantly increased. Radiographically, the fracture alignment was significantly improved after surgery compared to before surgery(P<0.05), additionally, the m LDTA angle and aADTA angle significantly improved postoperatively(P<0.05). Bony healing of the fractures was observed in all patients at about 10 weeks. [Conclusion] The cannulated screw fixation is a reliable treatment for distal tibial epiphyseal fractures in children with satisfactory short-term outcomes.
作者
韩立建
杨超
白洪勇
郝连升
HAN Li-jian;YANG Chao;BAI Hong-yong;HAO Lian-sheng(Department of Pediaric Orthopedics,Liaocheng Hospital of Traditional Chinese Medicine,Liaocheng 252000,China;Department of Traumatic Orhopedics,Liaocheng Hospital of Traditional Chinese Medicine,Liaocheng 252000,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2023年第6期571-573,576,共4页
Orthopedic Journal of China
关键词
儿童
胫骨远端骨骺骨折
空心螺钉
内固定
children
distal tibial epiphyseal fracture
cannulated screw
internal fixation
作者简介
韩立建,研究生,主治医师,研究方向:小儿骨科相关疾病的诊疗,(电话)15006376067,(电子信箱)fa48631@163.com;通信作者:郝连升,(电话)18769508279,(电子信箱)li27siv@163.com。
