摘要
胫骨远端过渡期骨折包括三平面骨折和Tillaux骨折,同时可能合并胫骨干骨折和腓骨近端骨折。胫骨远端过渡期骨折由踝关节损伤机制和胫骨远端骨骺闭合程度共同决定骨折类型。胫骨远端过渡期骨折累及骨骺,延迟治疗、不正确的治疗方式均可能造成骨骺早闭,进而导致踝关节畸形甚至残疾,需注意及时正确诊断。过渡期骨折三维CT检查可显示胫骨远端骨骺骨折线的走行,提高诊断率并方便内固定垂直骨折线有效置入。目前,过渡期骨折的治疗方式多样,包括闭合复位石膏固定、闭合或切开复位经皮克氏针/螺钉固定等,但并未获得普遍共识,治疗不当易造成关节功能障碍、引起骨关节炎等不良后果。因此,笔者对胫骨远端过渡期骨折的特点、诊断和治疗方法的研究进展进行综述,为临床治疗提供依据。
Transitional fracture of the distal tibia includes triplane fracture and Tillaux fracture and may combine with tibial shaft fracture or proximal fibular fracture.The fracture type is based on the mechanism of ankle injury and closure degree of the distal tibial epiphysis.Delayed or improper treatment may cause premature closure of the epiphysis in transitional fracture of the distal tibia,which may lead to ankle deformity or even disability,so it is necessary to pay attention to timely and correct diagnosis.Three-dimensional CT can show the fracture line of epiphysis of the distal tibia during the transitional period,which can improve the diagnostic rate and facilitate the effective placement for internal fixation.At present,there are various treatment methods for transitional fracture,including closed reduction with plaster fixation,closed or open reduction with percutaneous Kirschner wire or screw fixation,but a general consensus has not been reached.Improper treatment is likely to cause joint dysfunction,osteoarthritis and other adverse consequences.Therefore,the authors review the characteristics,diagnosis and treatment of transitional fracture of the distal tibia,in order to provide a reference for clinical treatment.
作者
贾国强
孙军
Jia Guoqiang;Sun Jun(Department of Orthopedics,Provincial Children′s Hospital of Anhui Medical University,Hefei 230051,China;Anhui Institute of Pediatric Research,Hefei 230051,China)
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2022年第12期1141-1146,共6页
Chinese Journal of Trauma
基金
国家自然科学基金(61976008)
安徽医科大学基金资助项目(2022xkj111)。
关键词
骨骺
胫骨骨折
青少年
过渡期
Epiphyses
Tibial fractures
Adolescent
Transition
