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目的:探讨闭合复位经皮空心钉内固定治疗儿童内踝Salter-HarrisⅢ型骨骺骨折的临床疗效。方法:自2011年1月至2015年8月共收治的儿童内踝Salter-HarrisⅢ型骨骺骨折患儿28例,其中男20例,女8例,年龄9~13岁,平均年龄为11岁3个月。采用C臂X线机透视下闭合手法复位,经皮空心螺钉内固定,术后应用石膏或支具外固定3~4周,去除外固定后逐渐下地负重、行走。结果:28例患儿均获得随访,平均随访时间25个月。术后3个月所有患儿均获得骨性愈合,2年左右的随访中未发现踝关节内外翻畸形、疼痛及不稳定等症状,无骺板早闭、骺板骨桥形成及关节面不平整现象,所有患儿均能参加正常的体育活动。按Baird-Jackson踝关节功能评分标准:优24例,良4例,获得优良率100%。结论:闭合复位经皮空心钉固定治疗儿童内踝Salter-HarrisⅢ型骨骺骨折,创伤小,内固定稳定可靠,疗效满意。
Objective: To investigate the clinical effect of closed reduction and percutaneous cannulated screw fixation for the treatment of Salter-Harris type Ⅲ epiphysis fracture in children. Methods: From January 2011 to August 2015, 28 children with Salter-Harris Ⅲ type epiphyseal fracture were included in this study. Among them, 20 were males and 8 were females, ranging in age from 9 to 13 years with a mean age of 11 years month. C-arm X-ray machine under fluoroscopy closed reduction, percutaneous fixation with hollow screws, postoperative plaster or brace external fixation for 3 to 4 weeks, remove the external fixation gradually under the weight, walking. Results: All 28 cases were followed up for an average of 25 months. At 3 months after operation, all children received bony union. No symptoms such as ankle deformity, pain and instability were observed in 2 years of follow-up. No epiphyseal plate early closure, epiphyseal plate bridge formation and articular surface were not found Smooth formation, all children can participate in normal physical activity. By Baird-Jackson ankle joint function score: excellent in 24 cases, good in 4 cases, excellent and good rate of 100%. Conclusion: Closed reduction and percutaneous cannulated screw fixation of Salter-Harris Ⅲ type epiphyseal fractures in children with medial malleolus has small trauma, stable and reliable internal fixation and satisfactory curative effect.