青少年胫骨结节撕脱骨折的治疗方式选择及疗效评价
Tibial tubercle avulsion fractures in adolescents:treatment and outcomes
阿卜杜萨拉木·玉苏音 1韩然1
作者信息
- 1. 新疆医科大学第六附属医院小儿骨科,乌鲁木齐 830063
- 折叠
摘要
目的 探讨青少年胫骨结节撕脱骨折的治疗方式选择及疗效.方法 回顾性分析2018年1月至2023年1月新疆医科大学第六附属医院小儿骨科收治并完整随访的16例青少年胫骨结节撕脱骨折患者资料.男15例,女1例;年龄(13.8±1.1)岁;致伤原因均为运动伤;骨折根据Ogden分型:Ⅰ型1例,Ⅱ型4例,Ⅲ型10例,Ⅴ型1例.保守治疗1例,闭合复位空心钉内固定2例,切开复位内固定13例.通过比较术前与末次随访时患儿的疼痛视觉模拟评分(VAS)、膝关节Lysholm评分分别评定疼痛和肢体功能恢复情况,并采用儿童青少年健康相关生存质量-10(KIDSCREEN-10)指数衡量生活质量.结果 16例患儿治疗后获(24.0±8.0)个月随访,2例患者分别出现10°、20°的膝关节屈伸活动受限,其余的14例患者在术后4.5(3.0,6.0)个月恢复了正常的膝关节活动;有4例患者诉偶发局部轻度疼痛,多在活动量增大时出现.所有患者在受伤后7.5(4.5,12.0)个月恢复到受伤前的体育活动水平.所有患者均无肌萎缩、感觉减退、骨筋膜室综合征、膝反张、感染、关节屈曲障碍、再骨折等并发症.末次随访时患儿的VAS评分[0(0,0.8)分]和Lysholm评分[96.0(96.0,100.0)]较术前[4.0(4.0,5.0)、0(0,19.5)分]显著改善,差异均有统计学意义(P＜0.05).所有患者KIDSCREEN-10指数均为50,术后生活质量指数为优,14例患者表示非常满意,2例患者表示满意.结论 对于青少年胫骨结节撕脱性骨折非移位或轻微移位骨折可以选择保守治疗,但要警惕骨筋膜间室综合征的发生.移位性骨折或伴髌腱断裂行切开复位内固定可获得满意的疗效.
Abstract
Objective To investigate the treatment and outcomes of tibial tubercle avulsion fractures in adolescents.Methods A retrospective study was conducted to review the 16 adolescents with tibial tu-bercle avulsion fracture who had been treated and completely followed up at Department of Pediatric Or-thopaedics,The Sixth Clinical Hospital Affiliated to Xinjiang Medical University from January 2018 to January 2023.There were 15 males and 1 female with an age of(13.8±1.1)years;all fractures were sports injuries.According to Ogden classification,there were 1 case of type Ⅰ,4 cases of type Ⅱ,10 cases of type Ⅲ,and 1 case of type Ⅴ.Conservative treatment was performed in 1 case,closed reduction and internal fixation with cannulated screws in 2 cases,and open reduction and internal fixation in 13 cases.Visual analogue scale(VAS)and joint Lysholm knee score were compared between preoperation and the last follow-up for pain and limb function assessments.KIDSCREEN-10 index was used to evaluate the quality of life of the patients.Results The 16 patients were followed up for(24.0±8.0)months after treatment.Two patients had respectively 10° and 20° limitation of knee flexion and extension;the other 14 patients regained full range of knee motion after 4.5(3.0,6.0)months.Four patients complained of occasional local mild pain,often occurring during increased activity.All patients recovered their pre-injury level of physical activity at 7.5(4.5,12.0)months after in-jury.None of the patients had muscle atrophy,hypoesthesia,osteofascial compartment syndrome,genu recur-vatum,infection,joint flexion disorder,or refracture.Their VAS score[0(0,0.8)points]and Lysholm score[96.0(96.0,100.0)]at the last follow-up were significantly improved compared with their preoperative scores[4.0(4.0,5.0)and 0(0,19.5)points](P＜0.05).All patients had a KIDSCREEN-10 index of 50,indicating their postoperative quality of life was excellent.Of the 16 patients,14 expressed great satisfac-tion and 2 satisfaction.Conclusions In the treatment of tibial tubercle avulsion fractures in adolescents,non-displaced or slightly displaced ones can be treated conservatively,but care should be taken to prevent oc-currence of osteofascial compartment syndrome.Open reduction and internal fixation can lead to good functional outcomes for displaced fractures or fractures with patellar tendon rupture.
关键词
青少年/胫骨骨折/骨折固定术,内/治疗结果Key words
Adolescents/Tibial fracture/Fracture fixation,internal/Treatment outcomes引用本文复制引用
出版年
2024
NETL
NSTL
万方数据