Mid- and long-term outcomes of surgical treatment for distal tibial physeal fractures.

Hayati Kart, Agshin Jabbarli, Mert Gündoğdu, Oytun Derya Tunç, Osman Mert Topkar, Özgür Baysal, Ahmet Hamdi Akgülle
{"title":"Mid- and long-term outcomes of surgical treatment for distal tibial physeal fractures.","authors":"Hayati Kart, Agshin Jabbarli, Mert Gündoğdu, Oytun Derya Tunç, Osman Mert Topkar, Özgür Baysal, Ahmet Hamdi Akgülle","doi":"10.14744/tjtes.2024.06474","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Distal tibial fractures are among the most common injuries in childhood. The treatment of distal tibial physeal fractures presents significant challenges for orthopedic surgeons, and potential complications are a major concern. The aim of this study is to evaluate the mid- and long-term outcomes of patients who underwent surgery for a distal tibial physeal fracture.</p><p><strong>Methods: </strong>This retrospective study included 46 patients who underwent surgery for a distal tibial physeal fracture between 2008 and 2022. Patients were evaluated based on the trauma that caused the fracture, the type of fracture (Salter-Harris classification), the type of reduction performed (open or closed), the type of implant used (K-wire or cannulated screw), the location of the fracture in the joint (intra-articular or extra-articular), and the presence of complications. The American Orthopaedic Foot and Ankle Society (AOFAS) score was used for clinical assessment.</p><p><strong>Results: </strong>The median age of the patients was 12 years (interquartile range [IQR] 10-14). The median follow-up time was 67 months (IQR 50.5-107). Postoperative anatomical reduction was achieved in 45 patients (97.8%), while 1 patient (2.2%) failed to achieve anatomical reduction. The median AOFAS score for all patients was 100 (IQR 90-100). Patients treated with K-wire fixation had a median score of 90 (IQR 86.5), while those treated with cannulated screws had a median score of 100 (IQR 92.5-100). Although the score for cannulated screws was statistically significantly higher (p=0.024), both groups demonstrated excellent clinical outcomes.</p><p><strong>Conclusion: </strong>Distal tibial physeal fractures are one of the most common childhood fractures and can lead to severe complications. The mid- and long-term outcomes of surgical treatment of distal tibial physeal fractures are favorable. The method of reduction (open or closed), the choice of implant (K-wire or cannulated screw), and the location of the fracture (intra-articular or extra-articular) do not affect outcomes or complications in patients with these injuries. The crucial factor in the treatment of distal tibial physeal fractures is achieving anatomical reduction.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 2","pages":"189-193"},"PeriodicalIF":0.0000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843419/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14744/tjtes.2024.06474","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Distal tibial fractures are among the most common injuries in childhood. The treatment of distal tibial physeal fractures presents significant challenges for orthopedic surgeons, and potential complications are a major concern. The aim of this study is to evaluate the mid- and long-term outcomes of patients who underwent surgery for a distal tibial physeal fracture.

Methods: This retrospective study included 46 patients who underwent surgery for a distal tibial physeal fracture between 2008 and 2022. Patients were evaluated based on the trauma that caused the fracture, the type of fracture (Salter-Harris classification), the type of reduction performed (open or closed), the type of implant used (K-wire or cannulated screw), the location of the fracture in the joint (intra-articular or extra-articular), and the presence of complications. The American Orthopaedic Foot and Ankle Society (AOFAS) score was used for clinical assessment.

Results: The median age of the patients was 12 years (interquartile range [IQR] 10-14). The median follow-up time was 67 months (IQR 50.5-107). Postoperative anatomical reduction was achieved in 45 patients (97.8%), while 1 patient (2.2%) failed to achieve anatomical reduction. The median AOFAS score for all patients was 100 (IQR 90-100). Patients treated with K-wire fixation had a median score of 90 (IQR 86.5), while those treated with cannulated screws had a median score of 100 (IQR 92.5-100). Although the score for cannulated screws was statistically significantly higher (p=0.024), both groups demonstrated excellent clinical outcomes.

Conclusion: Distal tibial physeal fractures are one of the most common childhood fractures and can lead to severe complications. The mid- and long-term outcomes of surgical treatment of distal tibial physeal fractures are favorable. The method of reduction (open or closed), the choice of implant (K-wire or cannulated screw), and the location of the fracture (intra-articular or extra-articular) do not affect outcomes or complications in patients with these injuries. The crucial factor in the treatment of distal tibial physeal fractures is achieving anatomical reduction.

胫骨远端骨骺骨折手术治疗的中长期疗效。
背景:胫骨远端骨折是儿童最常见的损伤之一。胫骨远端骨骺骨折的治疗对骨科医生提出了重大挑战,潜在的并发症是一个主要问题。本研究的目的是评估手术治疗胫骨远端骨骺骨折患者的中期和长期预后。方法:本回顾性研究纳入了2008年至2022年间接受胫骨远端骨骺骨折手术的46例患者。根据导致骨折的创伤、骨折类型(Salter-Harris分类)、复位类型(开放式或封闭式)、使用的植入物类型(k -钢丝或空心螺钉)、骨折在关节中的位置(关节内或关节外)以及是否存在并发症对患者进行评估。采用美国骨科足踝学会(AOFAS)评分进行临床评估。结果:患者年龄中位数为12岁(四分位数间距[IQR] 10-14)。中位随访时间为67个月(IQR 50.5-107)。术后解剖复位45例(97.8%),解剖复位失败1例(2.2%)。所有患者的AOFAS评分中位数为100 (IQR 90-100)。采用k线固定治疗的患者中位评分为90 (IQR为86.5),而采用空心螺钉治疗的患者中位评分为100 (IQR为92.5-100)。虽然空心螺钉组的评分有统计学意义(p=0.024),但两组均表现出良好的临床结果。结论:胫骨远端骨骺骨折是儿童最常见的骨折之一,可导致严重的并发症。手术治疗胫骨远端骨骺骨折的中长期疗效良好。复位方法(开放或闭合)、植入物的选择(克氏针或空心螺钉)以及骨折的位置(关节内或关节外)不影响这些损伤患者的预后或并发症。治疗胫骨远端骨骺骨折的关键因素是实现解剖复位。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信