三维CT引导下切开复位内固定治疗青少年移位的Salter-Harris Ⅱ型旋前-外翻外旋型胫骨远端骨骺骨折的效果分析

Effect of three-dimensional CT-guided open reduction and internal fixation in the treatment of displaced Salter-Harris Ⅱ pronation-eversion-external rotation distal tibial epiphyseal fractures in adolescents

摘要:

目的 探讨三维CT引导下切开复位内固定（ORIF）治疗青少年移位的Salter-Harris Ⅱ型旋前-外翻外旋型胫骨远端骨骺骨折的效果。方法 前瞻性分析2020年1月—2023年7月南通市第三人民医院收治的108例青少年移位的Salter-Harris Ⅱ型旋前-外翻外旋型胫骨远端骨骺骨折患者，按随机数字表法分为观察组和对照组，每组54例。对照组采取常规ORIF治疗，观察组采取三维CT引导下ORIF治疗，对比两组手术效果。结果 观察组与对照组术前视觉模拟评分（VAS）比较，差异无统计学意义（P >0.05）。观察组手术时间、住院时间和骨折愈合时间均短于对照组（P <0.05），术中出血量和术后1个月VAS评分低于对照组（P <0.05）。观察组骨折愈合效果优于对照组（P <0.05）。观察组出院当天与出院后6个月踝-后足评分系统评分的下降程度大于对照组（P <0.05）。观察组并发症发生率低于对照组（P <0.05）。结论 青少年移位的Salter-Harris Ⅱ型旋前-外翻外旋型胫骨远端骨骺骨折患者采取三维CT引导下ORIF治疗，可显著提高踝关节功能，减轻患者疼痛程度，降低并发症发生率，值得推广。

Abstract:

Objective To investigate the effect of three-dimensional CT-guided open reduction and internal fixation (ORIF) in the treatment of displaced Salter-Harris Ⅱ pronation-eversion-external rotation distal tibial epiphyseal fractures in adolescents.Methods A prospective analysis was performed on 108 adolescents with displaced Salter-Harris Ⅱ pronation-eversion-external rotation distal tibial epiphyseal fractures admitted to Nantong Third People's Hospital from January 2020 to July 2023. The patients were divided into the observation group and the control group by the random number table method, with 54 cases in each group. The control group received conventional ORIF treatment, and the observation group received three-dimensional CT-guided ORIF treatment. The surgical outcomes of the two groups were compared.Results There was no significant difference in preoperative VAS scores between the observation group and the control group (P > 0.05). The operative duration, length of hospital stay and fracture healing time of the observation group were shorter than those of the control group (P < 0.05), while the intraoperative blood loss and VAS scores 1 month after the surgery in the observation group were lower than those in the control group (P < 0.05). The fracture healing outcomes of the observation group were better than those of the control group (P < 0.05). The decline in AOFAS scores 6 months after discharge, compared to the scores on the day of discharge, was greater in the observation group than in the control group (P < 0.05). The incidence of complications in the observation group was lower than that in the control group (P < 0.05).Conclusions The use of three-dimensional CT-guided ORIF for adolescent patients with displaced Salter-Harris II pronation-eversion-external rotation distal tibial epiphyseal fractures can significantly improve ankle joint function, alleviate pain, and reduce the incidence of complications, making it a treatment worth promoting.