摘要
儿童胫骨棘撕脱骨折是一种较少见的关节内骨折。作者介绍了该骨折的诊断与分型、受伤机制及治疗方法的选择。对该骨折的治疗，作者早期多采用切开复位手术治疗。近１０年来改变了以往的治疗原则基本上根据Ｍｅｙｅｒ’ｓ和Ｍｃｋｅｅｖｅｒ提出的分型进行治疗，首先应十分熟悉该骨折的分型才能正确进行治疗。对Ｉ、ＩＩ型和第ＩＩＩ型大部分采取保守治疗效果是满意的，而对手术适应证掌握在骨折移位严重或骨片有翻转的病例。自１９８０～１９９３年共收治了２５例，手术的７例中ＩＩ型２例，ＩＩＩ型５例。保守治疗１８例中Ｉ型２例，ＩＩ型６例，ＩＩＩ型１０例。手术治疗采用切开复位钢丝内固定。保守治疗采用膝关节伸直位长腿石膏固定６周。随访１８例中手术者７例。保守治疗者１１例。两种治疗效果均满意。
AbstractAvulsion frac ture of the in tercondylar emi nence ofthe tibia in children,. an intra-articular fracture israrely seen. The classification of this condition is basedon the degree of the displacement of the fractured fracg-ment. Type 1 avulsion fracture of the intercondylar em-inece has no displacemnt, type II fracture has 1/3～1/2of the anterior portion of the fragment eievated from thetibial plateau and type III has complete detachment ofthe fragment. Approximately 80%belongs to types Iand II and 15%belongs to the type III. Zaricznyj fur-ther classifled type III into A and B subtapes accordingto the presence or absence of rotational displacements.He also named the comminuted fractures as type IV.The fracture is produced from the pull of the anteriorcrucial ligament. The management of type I and most ofthe type II, is conservative with long leg cast for 6weeks, and open reduction is the method of choice forthe type III fractures. The authors reported 25 cases en-cauntered from 1980 to 1993. Surgical treatment wasdone in 7 cases, of which 2 were type II and 5 were typeIII fractures. The operative procedure consisted of wirefixation of the fragment.II cases treated conservativelyand 7 cases operated upon had follow-up. The resultswere all satisfactory.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1995年第7期422-424,共3页
Chinese Journal of Orthopaedics
