All-epiphyseal versus trans-epiphyseal screw fixation for tillaux fractures:Does it matter?  

作　　者：Brett Heldt Isaiah Roepe Raymond Guo Elsayed Attia Ifeoma Inneh Vinitha Shenava Indranil Kushare 

机构地区：[1]Department of Orthopedic Surgery,Baylor College of Medicine,Houston,TX 77030,United States [2]Department of Orthopedic Surgery,Texas Children's Hospital,Houston,TX 77030,United States

出　　处：《World Journal of Orthopedics》2022年第2期131-138,共8页世界骨科杂志（英文版）

摘　　要：BACKGROUND Tillaux fractures occur primarily in adolescents due to the pattern of physeal closure and are classified as Salter-Harris type III physeal fractures.Operative management with screw fixation is recommended for more than 2 mm of displacement or more than 1 mm of translation.However,the efficacy and complications of trans-physeal vs all-physeal screw fixation have not been investigated extensively.AIM To compare the clinical and functional outcomes of trans-physeal(oblique)and all-epiphyseal(parallel)screw fixation in management of Tillaux fractures among pediatric patients.METHODS This was an ethics board approved retrospective review of pediatric patients who presented to our tertiary children’s care facility with Tillaux fractures.We included patients who had surgical fixation of a Tillaux fracture over a 10 year period.Data analysis included demographics,mode of injury,management protocols,and functional outcomes.The patients were divided into group 1(oblique fixation)and group 2(parallel fixation).Baseline patient characteristics and functional outcomes were compared between groups.Statistical tests to evaluate differences included Fisher’s Exact or Chi-squared and independent samples t or Mann Whitney tests for categorical and continuous variables,respectively.RESULTS A total of 42 patients(28 females and 14 males)were included.There were no significant differences in body mass index,sex,age,or time to surgery between the groups[IK2].Sports injuries accounted for 61.9%of the cases,particularly non-contact(57.1%)and skating(28.6%)injuries.Computed Tomography(CT)scan was ordered for 28 patients(66.7%),leading to diagnosis confirmation in 17 patients and change in management plan in 11 patients.[GRC3]Groups 1 and 2 consisted of 17 and 25 patients,respectively.For mid to long-term functional outcomes,there were 14 and 10 patients in groups 1 and 2,respectively.Statistical analysis revealed no significant differences in the functional outcomes,pain scores,or satisfaction between groups.No infections

关 键 词：Tillaux fracture Orthopedic surgery Fixation technique Functional outcomes 

分 类 号：R687.3[医药卫生—骨科学]