中国临床解剖学杂志 ›› 2019, Vol. 37 ›› Issue (6): 708-711.doi: 10.13418/j.issn.1001-165x.2019.06.019

• 临床研究 • 上一篇    下一篇

二齿钩钢板短期固定治疗骨骺未闭合青少年撕脱性骨折

殷渠东1, 顾三军1, 韩晓飞1, 芮永军1, 吴永伟1, 周子红2   

  1. 1.无锡市第九人民医院骨科,  江苏   无锡    214062; 2.无锡市人民医院骨科,  江苏   无锡    214000
  • 收稿日期:2018-02-28 出版日期:2019-11-25 发布日期:2019-12-03
  • 作者简介:殷渠东(1965-),男,四川蓬安人,主任医师,主要研究方向为创伤骨科, E-mail:yinqudong@sina.com

Short-term fixation of two teeth hook plate for treating avulsion fracture in adolescents with no-closed epiphysis 

YIN Qu-dong1, GU San-jun1, HAN Xiao-fei1, RUI Yong-jun1, WU Yong-wei1, ZHOU Zi-hong2   

  1. 1. Department of Orthpaedics, Wuxi No.9 People’s Hospital, Wuxi 214062, Jiangsu Province; 2. Department of Orthpaedics, Wuxi People’s Hospital, Wuxi 214000, Jiangsu Province, China
  • Received:2018-02-28 Online:2019-11-25 Published:2019-12-03

摘要: 目的 探讨二齿钩钢板短期固定治疗骨骺未闭合青少年撕脱性骨折效果。  方法 2012年1月~2016年11月,应用二齿钩钢板短期固定治疗骨骺未闭合青少年新鲜撕脱性骨折22例,其中男13例,女9例;年龄10~15岁,平均13.0岁;骨折类型(Salter-Harris分类):I型8例,II型10例,III型3例,IV型1例;骨折部位:尺骨鹰嘴6例,肱骨内上髁4例,肱骨外上髁4例,肱骨大结节2例,外踝4例,内踝2例。术后均早期康复活动。骨愈合后及时取出内固定物。所有患者获12~28个月(平均18.2个月)随访。按DASH上肢功能调查表和Kaikkonen踝关节损伤功能评分,评价患肢功能恢复情况。  结果 切口均I期愈合,无血管神经损伤和感染。骨折均顺利愈合,未见移位和延迟愈合,无内固定松动或断裂。末次随访,患肢关节功能恢复优良率100%,无关节不稳,无明显骨骼发育畸形和创伤性关节炎。  结论 二齿钩钢板短期固定对骨骺或骺板无继发性、医源性损伤,是骨骺未闭合青少年撕脱性骨折较好的内固定方法,需注意勿过度加压和控制固定时间。

关键词: 骨骺损伤,  ,  , 撕脱性骨折,  内固定,  钩钢板

Abstract: Objective To explore the effect of short-term fixation of two teeth hook plate on avulsion fracture in adolescents with no-closed epiphysis.  Methods  From January 2012 to November 2016, 22 cases of fresh avulsion fracture in adolescents with no-closed epiphysis were treated with short-term fixation of two teeth hook plate, of which were 13 males and 9 females, whose age ranged between 10 ~ 15 years old, with a mean of 13.0 years old. For the Salter-Harris type: type I in 8 cases, type II in 10 cases, type III in 3 cases and type IV in one case. For location of fracture type: ulna olecranon in 6 cases, humeral medial epicondyle in 4 cases, humeral lateral epicondyle in 4 cases, humeral greater tuberosity in 2 cases, lateral malleolus in 4 cases and medial malleolus in 2 cases. Early postoperative rehabilitation were all taken. After the fracture healed, the internal fixator was removed timely. All patients were followed up for 12 to 28 months (averaging 18.2 months). The functionary recovery of limb was evaluated based on the upper limb function score (DASH) and Kaikkonen’s ankle injury score respectively. Results The incisions healed by first intention. No vascular or nerve injury and infection, no loosening or broken of internal fixator were observed. All the avulsion fractures were smoothly healed without fracture displacement and delayed healing. During the last follow-up, the good rate of functional recovery was 100%, there were no instability of joint, no skeletal dysplasia and no traumatic arthritis. Conclusions Short-term fixation of two teeth hook plate has no secondary, iatrogenic injury to the epiphysis or epiphyseal plate, which is indicated for avulsion fracture in adolescents with no-closed epiphysis, but over compression and long-time fixation should be avoided.

Key words:  , Epiphyseal injury,  Avulsion fracture,  Internal fixation,  Hook plate 

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