CAJ | 학술논문

　　目的探讨青少年胫骨结节撕脱性骨折的治疗、并发症及预后。方法2004年1月至2012年9月治疗的18例胫骨结节撕脱性骨折患者，均为男性，年龄12.8～17.1岁，平均14.3岁，左侧11例，右侧7例，均为单侧。其中，1例为手法复位石膏外固定术后再次出现同侧骨折。按照改良的 Ogden 分型将上述骨折(19例骨折)进行分型：I A：1例，II A：2例，II B：2例，III A：4例，III B：6例，IV B：3例， V B：1例。采用闭合复位长腿石膏外固定6例，切开复位内固定治疗13例。按 I～III 型和 IV、V型骨折对术后并发症进行分组比较，用 SPSS18.0软件进行统计学分析，采用χ2检验。结果18例患者获得平均13个月(6～36个月)随访，骨折愈合时间8～20周(平均12周)，按 Mosier 评估标准对患者膝关节功能进行评估，所有患者结果均为优。IV、V型骨折行石膏外固定术后出现2例并发症，多于 I～III 型术后并发症( P＜0.05)。结论对于有移位、粉碎性和(或)累及关节面的胫骨结节撕脱性骨折应行切开复位内固定，可采用空心拉力螺钉内固定治疗，可以达到满意的疗效。
　　목적탐토청소년경골결절시탈성골절적치료、병발증급예후。방법2004년1월지2012년9월치료적18례경골결절시탈성골절환자，균위남성，년령12.8～17.1세，평균14.3세，좌측11례，우측7례，균위단측。기중，1례위수법복위석고외고정술후재차출현동측골절。안조개량적 Ogden 분형장상술골절(19례골절)진행분형：I A：1례，II A：2례，II B：2례，III A：4례，III B：6례，IV B：3례， V B：1례。채용폐합복위장퇴석고외고정6례，절개복위내고정치료13례。안 I～III 형화 IV、V형골절대술후병발증진행분조비교，용 SPSS18.0연건진행통계학분석，채용χ2검험。결과18례환자획득평균13개월(6～36개월)수방，골절유합시간8～20주(평균12주)，안 Mosier 평고표준대환자슬관절공능진행평고，소유환자결과균위우。IV、V형골절행석고외고정술후출현2례병발증，다우 I～III 형술후병발증( P＜0.05)。결론대우유이위、분쇄성화(혹)루급관절면적경골결절시탈성골절응행절개복위내고정，가채용공심랍력라정내고정치료，가이체도만의적료효。
Objective To report the results of the management of avulsion fracture of proximal tibial tubercle, with a particular reference to the prognosis and complications in adolescents. Methods 18 patients ( all boys ) with tibial tuberosity fracture were included in the present series. The mean age of patients was 14.3 years old, ranging from 12.8 to 17.1 years. 11 fractures were involved at the left side while 7 at the right side. All were unilateral fractures. According to the modified system of Ogden classification, there were 1 type I A, 2 type II A, 2 type II B, 4 type III A, 6 type III B, 3 type IV B and 1 type V B fractures. 6 cases were treated with closed reduction and immobilization with plaster cast, but refracture occurred in one of the cases, which was then treated surgically. The total 13 patients were operated upon with open reduction and internal fixation. SPSS18.0 software package was used for statistical analysis with chi-square test, comparing the complication rates of type I-III and type IV-V fractures. Results 18 patients were followed up for an average of 13 months ( range;6-36 months ). The mean healing time of the fracture was 12 weeks ( range;8-20 weeks ). According to the assessment system described by Mosier and Stanitski, the knee joint function was excellent in all cases. 2 patients of type IV-V fractures, who were performed with plaster external fixation, had complications, whereas none occurred in those of type I-III fracture ( P<0.05 ). Conclusions Open reduction and internal fixation should be recommended for the management of the facture with remarkable displacement, comminution or the facture involving the articular surface. The treatment with hollow lag screw fixation could achieve good results.