空心螺钉选择性治疗儿童胫骨远端骨骺损伤

目的 探讨空心螺钉内固定治疗儿童胫骨远端骨骺损伤的临床疗效.方法 选取2004年9月至2011年5月收治的儿童胫骨远端骨骺损伤患者40例,男28例,女12例.根据Salter-Harris分型标准,Ⅱ型24例,Ⅲ型10例（其中Tillaux骨折2例,三平面骨折1例）,Ⅳ型6例.其中采用闭合手法复位15例,手术复位25例.所有患者均采用空心螺钉内固定,术后应用石膏或支具外固定6~8周.结果 40例患者均获得随访8～66个月,平均23个月.所有患者均骨性愈合,未发现骨桥形成、骨骺早闭及关节面不平整现象,无踝关节内外翻畸形,所有患儿均能参加正常的体育活动.按改良Weber评分,优34例,良6例,差0例,优良率达100%.结论 空心螺钉选择性的应用于儿童胫骨远端骨骺损伤,固定可靠,疗效满意,最大限度地恢复了关节功能,是一种有效和较为理想的方法.

The cannulated screws for children distal tibial epiphyseal injuries

Objective To assess the cannulated screws for children distal tibial epiphyseal. Methods 40 children distal tibial epiphyseal were treated by assess the cannulated screws from September 2004 to May 2011, 28 males and 12 females. Ac- cording to the Salter-Harris classification criteria, Type I124 cases, 10 cases of type m 〈 Tillaux fractures in 2 cases, three-plane fracture 1 cases）, 6 cases of type IV. Which closed manipulative reduction and 15 cases, 25 cases of surgical reduction. All pa- tients were treated with cannulated screw fixation, Piaster or brace external fixation 6 to 8 weeks after application. Results All patients were followed from 8 to 66 months （ mean 23 months）. All cases were bone healing. No bone bridge formation, early clo- sure of epiphyseal and articular surface uneven, no ankle varus-valgus deformity. All children can participate in regular sports. According to the modified Weber score, excellent in 34 cases, good in 6 cases and poor in 0 cases, excellent rate of 100%. Con- clusion The cannulated screws for children distal tibial epiphyseal injuries, reliable fixation, the results were satisfactory, the joint function has been to recover maximize, it is an effective and ideal method.