【摘要】：目的：探討兒童踝關(guān)節(jié)骨骺骨折的治療、分型以及影響預(yù)后的因素。 方法：收集我院骨科病房從2008年1月到2010年1月收治的53例踝關(guān)節(jié)骨骺骨折病例資料，對(duì)踝關(guān)節(jié)骨骺骨折患兒的受傷原因、損傷分型、治療方法及隨訪結(jié)果進(jìn)行分析。53例患兒中男32例，女21例，年齡4-15歲。受傷原因包括輕微傷（平地跌倒）12例，劇烈運(yùn)動(dòng)損傷以及低于3米的墜落傷18例，高能量損傷如高處墜落傷和車(chē)禍傷23例。所有病例按Salter-Harris分型方法進(jìn)行分型：Ⅰ型損傷10例，Ⅱ型損傷19例，Ⅲ型損傷13例，Ⅳ型損傷7例，混合損傷即粉碎性骨折（三平面骨折）4例。治療方法涉及保守治療28例，手術(shù)治療25例，手術(shù)方法包括切開(kāi)復(fù)位和閉合復(fù)位2種手術(shù)固定方法包括：克氏針固定6例，空心螺釘固定13例，可吸收釘固定4例，鋼板螺釘固定2例，術(shù)后采用石膏固定，4-8周拆除石膏逐步開(kāi)始功能鍛煉。 結(jié)果：全部病例獲得隨訪24-36個(gè)月,平均26個(gè)月，隨訪結(jié)果采用Cottalorda J等[1]評(píng)定標(biāo)準(zhǔn)進(jìn)行評(píng)估。保守治療病例隨訪結(jié)果：優(yōu)20例，良6例，差2例，優(yōu)良率93%。手術(shù)治療隨訪結(jié)果為優(yōu)15例，良3例，，差7例，優(yōu)良率72%。 結(jié)論：(1)兒童踝關(guān)節(jié)骨骺骨折病因以中低能量即運(yùn)動(dòng)性損傷為主，車(chē)禍所致的高能量損傷所占比重有上升趨勢(shì)。 (2)影響兒童踝關(guān)節(jié)骨骺損傷預(yù)后的因素包括骨骺損傷程度、類(lèi)型、骨折復(fù)位情況以及受傷就診時(shí)間。 (3)兒童踝關(guān)節(jié)骨骺骨折同時(shí)涉及骺板、關(guān)節(jié)面及踝關(guān)節(jié)穩(wěn)定性，應(yīng)盡量早期診斷和治療，根據(jù)骨骺損傷的分型、移位程度等采用最適宜的治療方法，盡可能解剖復(fù)位，減少對(duì)骺板的干擾，以提高療效和減少并發(fā)癥發(fā)生。
[Abstract]:Objective: to investigate the treatment, classification and prognostic factors of ankle epiphyseal fracture in children. Methods: 53 cases of ankle epiphyseal fracture were collected from January 2008 to January 2010 in orthopedic ward of our hospital. The causes and types of injuries in children with ankle epiphyseal fracture were analyzed. Methods of treatment and follow-up results were analyzed. There were 32 males and 21 females, aged 4-15 years. The injuries included 12 cases of mild injury (flat fall), 18 cases of severe exercise injury, 18 cases of falling injury below 3 meters, and 23 cases of high energy injury such as high fall injury and car accident injury. All cases were classified according to Salter-Harris 's classification method: 10 cases of type 鈪

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