CAJ | 학술논문

目的探讨经皮微创锁定加压钢板固定治疗儿童胫骨远干骺端骨折的疗效.方法 2006年1月至2008年6月采用闭合复位经皮插入锁定加压钢板内固定治疗儿童胫骨远干骺端骨折17例.男13例,女4例;年龄8岁7个月至14岁,平均12岁1个月.根据AO儿童长骨骨折分型:43-M/3.1型12例,43-M/3.2型3例.43t-M/3.1型2例;其中开放性骨折2例(Gustilo Ⅰ型).结果所有患儿均获随访.随访时间10～35个月,平均26个月;骨折均获骨性愈合,愈合时间2.5～4.2个月,平均3.2个月.根据美国足踝外科协会(AOFAS)评分系统对踝关节功能评分:优15例(88.2%),良2例(11.8%),优良率100%.伤侧肢体过度生长-5mm～11mm,平均3mm.切口浅表感染、内植物局部不适及内固定物取出困难各1例.无深部感染及皮肤坏死,未出现断钉、内同定松动及继发骨折移位,无骨折迟延愈合、不愈合、畸形愈合及内植物取出后再骨折,无踝关节内外翻畸形等并发症.结论经皮微创锁定加压钢板同定治疗大龄儿童胫骨远干骺端骨折符合BO理念,具有创伤小、固定牢靠、有利于骨折愈合及软组织的修复、术后可早期行关节功能练习等优点,是一种有效的内固定方法.
목적 탐토경피미창쇄정가압강판고정치료인동경골원간후단골절적료효.방법 2006년1월지2008년6월채용폐합복위경피삽입쇄정가압강판내고정치료인동경골원간후단골절17례.남13례,녀4례;년령8세7개월지14세,평균12세1개월.근거AO인동장골골절분형:43-M/3.1형12례,43-M/3.2형3례.43t-M/3.1형2례;기중개방성골절2례(Gustilo Ⅰ형).결과 소유환인균획수방.수방시간10～35개월,평균26개월;골절균획골성유합,유합시간2.5～4.2개월,평균3.2개월.근거미국족과외과협회(AOFAS)평분계통대과관절공능평분:우15례(88.2%),량2례(11.8%),우량솔100%.상측지체과도생장-5mm～11mm,평균3mm.절구천표감염、내식물국부불괄급내고정물취출곤난각1례.무심부감염급피부배사,미출현단정、내동정송동급계발골절이위,무골절지연유합、불유합、기형유합급내식물취출후재골절,무과관절내외번기형등병발증.결론 경피미창쇄정가압강판동정치료대령인동경골원간후단골절부합BO이념,구유창상소、고정뢰고、유리우골절유합급연조직적수복、술후가조기행관절공능연습등우점,시일충유효적내고정방법.
Objective To explore the efficacy of minimally invasive percutaneous locking compression plate(LCP)internal fixation in the treatment of metaphyseal fracture of distal tibia in children.Methods Between January 2006 and June 2008,13 males and 4 females with metaphyseal fracture of distal tibia underwent minimally invasive percutaneous locking compression plate(LCP) internal fixation at this center. The average age of these patients was 12 years and 1 month old(range,8 years and 7 months to 14 years).According to the AO comprehensive classification of pediatric long bone fractures,12 cases were classified as type 43-M/3.1,3 were 43-M/3.2 and 2 were 43t-M/3.1.Of the 17 patients,2 were open fracture(Gustilo type Ⅰ).Results All the patients were followed up for an average period of 26 months(range,10 to 35 months).All the fractures healed well and the average healing time was 3.2 months(range,2.5 to 4.2 months).The ankle functions of the patients were evaluated according to the AOFAS scoring system.Fifteen patients'ankle function(88.2%)were graded as excellent,2(11.8%)were good.The average leg length discrepancy was 3 mm(range,-0.5 to 11 mm).Superficial infection occurred in 1 case.One patient felt uncomfortable around the implant.The implant was removed with some difficulties in 1 case.No Other complications were noted.Conclusions Minimally invasive percutaneous locking compression plate osteosynthesis is an effective treatment for metaphyseal fracture of distal tibia in children.