儿童踝关节骨骺骨折

发布时间：2019-03-18 13:40

【摘要】：目的：探讨儿童踝关节骨骺骨折的治疗、分型以及影响预后的因素。 方法：收集我院骨科病房从2008年1月到2010年1月收治的53例踝关节骨骺骨折病例资料，对踝关节骨骺骨折患儿的受伤原因、损伤分型、治疗方法及随访结果进行分析。53例患儿中男32例，女21例，年龄4-15岁。受伤原因包括轻微伤（平地跌倒）12例，剧烈运动损伤以及低于3米的坠落伤18例，高能量损伤如高处坠落伤和车祸伤23例。所有病例按Salter-Harris分型方法进行分型：Ⅰ型损伤10例，Ⅱ型损伤19例，Ⅲ型损伤13例，Ⅳ型损伤7例，混合损伤即粉碎性骨折（三平面骨折）4例。治疗方法涉及保守治疗28例，手术治疗25例，手术方法包括切开复位和闭合复位2种手术固定方法包括：克氏针固定6例，空心螺钉固定13例，可吸收钉固定4例，钢板螺钉固定2例，术后采用石膏固定，4-8周拆除石膏逐步开始功能锻炼。 结果：全部病例获得随访24-36个月,平均26个月，随访结果采用Cottalorda J等[1]评定标准进行评估。保守治疗病例随访结果：优20例，良6例，差2例，优良率93%。手术治疗随访结果为优15例，良3例，，差7例，优良率72%。 结论：(1)儿童踝关节骨骺骨折病因以中低能量即运动性损伤为主，车祸所致的高能量损伤所占比重有上升趋势。 (2)影响儿童踝关节骨骺损伤预后的因素包括骨骺损伤程度、类型、骨折复位情况以及受伤就诊时间。 (3)儿童踝关节骨骺骨折同时涉及骺板、关节面及踝关节稳定性，应尽量早期诊断和治疗，根据骨骺损伤的分型、移位程度等采用最适宜的治疗方法，尽可能解剖复位，减少对骺板的干扰，以提高疗效和减少并发症发生。
[Abstract]:Objective: to investigate the treatment, classification and prognostic factors of ankle epiphyseal fracture in children. Methods: 53 cases of ankle epiphyseal fracture were collected from January 2008 to January 2010 in orthopedic ward of our hospital. The causes and types of injuries in children with ankle epiphyseal fracture were analyzed. Methods of treatment and follow-up results were analyzed. There were 32 males and 21 females, aged 4-15 years. The injuries included 12 cases of mild injury (flat fall), 18 cases of severe exercise injury, 18 cases of falling injury below 3 meters, and 23 cases of high energy injury such as high fall injury and car accident injury. All cases were classified according to Salter-Harris 's classification method: 10 cases of type 鈪

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