晚期出现股骨远端关节内骨折的手术治疗结果:多中心回顾性病例系列。

IF 1.1 4区 医学 Q3 ORTHOPEDICS
Indian Journal of Orthopaedics Pub Date : 2024-11-29 eCollection Date: 2024-12-01 DOI:10.1007/s43465-024-01291-4
Jaswinder Singh, Hitesh Shah, K Venkatadass, Janki Sharan Bhadani, John Mukhopadhaya
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引用次数: 0

摘要

儿童股骨远端骨骺骨折,特别是Hoffa骨折,是罕见且容易发生并发症。本研究旨在评估手术干预儿童迟发性股骨远端关节内骨骺骨折的结果。一项多中心回顾性研究涉及6例延迟表现为股骨远端骨骺骨折的儿童患者。5例患者接受手术干预,包括截骨和畸形碎片的解剖重新固定。1例患者选择保守治疗。在最后随访时评估患者的发病年龄、受伤时间、手术方式以及临床和放射学结果。3例患者用拉力螺钉固定就足够了,2例需要额外的钢板稳定。患者平均年龄12.2岁,包括4名男孩和2名女孩。平均延迟30.8个月(3个月至8年不等)。对于手术组(n = 5),平均随访60个月,膝关节活动范围从术前平均16°-66°改善到术后平均6°-128°。平均肢体缩短3cm (0.5 ~ 5cm)。2例患者因股骨远端内翻畸形需要额外的手术。保守治疗的患者在12个月的随访中膝关节活动没有改善,作为对照。儿童股骨远端salter - harris III型和IV型骨折关节内畸形愈合的手术干预包括截骨和解剖复位,可获得良好到极好的结果。肢体长度不一致和不对准,如果存在,可以单独解决。对这些患者进行更长时间的随访,直到骨骼成熟,以评估最终结果。证据等级:四级(病例系列)。治疗。补充资料:在线版本包含补充资料,下载地址:10.1007/s43465-024-01291-4。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcomes of Surgical Management of Late Presenting Intra-Articular Distal Femoral Physeal Fracture: A Multicentric Retrospective Case Series.

Distal femur physeal fractures in children, particularly Hoffa fractures, are rare and prone to complications. This study aims to evaluate the outcomes of surgical intervention in children presenting with delayed intra-articular distal femur physeal fractures. A multicentric retrospective study involved six pediatric patients with delayed presentation of distal femur physeal fractures. Five patients underwent surgical intervention involving osteotomy and anatomical re-fixation of the malunited fragments. One patient opted for conservative management. The age at presentation, time since injury, surgical procedures, and clinical and radiological outcomes were evaluated at the final follow-up. Fixation with lag screws was sufficient in three patients, while two required additional plate stabilization. The mean age of patients was 12.2 years, comprising four boys and two girls. The average delay in presentation was 30.8 months (ranging from 3 months to 8 years). For the surgical group (n = 5), the knee range of motion improved from an average of 16°-66° preoperatively to 6°-128° post-operatively at a mean follow-up of 60 months. The mean limb shortening was 3 cm (range 0.5-5 cm). Two patients required additional procedures for distal femur varus malalignment. The conservatively managed patient showed no improvement in knee movements at the 12-month follow-up, serving as a control. Surgical intervention involving osteotomy and anatomical reduction for malunited intra-articular Salter-Harris-type III and IV fractures of the distal femur in children yields good to excellent outcomes. Limb length discrepancy and malalignment, if present, can be addressed separately. Longer follow-up until skeletal maturity is necessary to evaluate final outcomes in these patients. Level of evidence: Level IV (case series). Therapeutic.

Supplementary information: The online version contains supplementary material available at 10.1007/s43465-024-01291-4.

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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
185
审稿时长
9 months
期刊介绍: IJO welcomes articles that contribute to Orthopaedic knowledge from India and overseas. We publish articles dealing with clinical orthopaedics and basic research in orthopaedic surgery. Articles are accepted only for exclusive publication in the Indian Journal of Orthopaedics. Previously published articles, articles which are in peer-reviewed electronic publications in other journals, are not accepted by the Journal. Published articles and illustrations become the property of the Journal. The copyright remains with the journal. Studies must be carried out in accordance with World Medical Association Declaration of Helsinki.
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