Management of fracture of the proximal tibial epiphysis in children(19 cases) / 重庆医学

ABSTRACT

Objective To inoertyate the results of the management of fracture of the proximal tibial epiphysis ,with a particu‐lar reference to the prognosis and complications in children .Methods From January 2002 to June 2012 ,a total of 19 children with fracture of the proximal tibial epiphysis were reviewed ,10 cases were treated with closed reduction and immobilization with plaster cast ,9 patients were operated upon with open reduction and internal fixation .Results All the patients were available at the final follow up with a mean of 2 .8 years (range ,2‐4 .8 years) ,The mean healing time of the fracture was 11 .8 weeks (range ,8 .5‐20 weeks) .According to the assessment system described by Lysholm ,the knee joint function of patients was 13 excellent ,4 good ,1 better and 1 poor .1 case occurred traumatic arthritis ,leading to the pain of keen ,One patient had epiphyseal plate closed early ,and one patient had genu valgum .Conclusion Open reduction and internal fixation should be recommended for the management of the facture with remarkable displacement of type Ⅰ and type Ⅱ ,or the facture involving the articular surface collapses more than 5 mm or separates more than 2 mm of type Ⅲ and type Ⅳ .The treatment with Kirschenel wires or hollow lag screw fixation could achieve good results .