Fractures of The Talus-Differences Between Children and Adolescents
Fractures of The Talus-Differences Between Children and Adolescents
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DOI：
10.1097/ta.0b013e3181a74667
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发表时间：
2010-01-01
影响因子：
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通讯作者：
Hoellwarth, Michael E.
中科院分区：
文献类型：
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作者：
Eberl, Robert;Singer, Georg;Hoellwarth, Michael E.
背景：距骨骨折代表足部骨骼的严重损伤。最显着的并发症包括骨坏死和创伤后排列不齐继发的关节炎。我们研究的目的是比较儿童和青少年距骨骨折的治疗和结果。方法：从 1990 年到 2005 年，24 名患者（18 名男性，6 名女性）出现 25 处距骨骨折。对医疗记录进行了回顾性审查。通过放射照相分级进行随访，并使用足功能指数测量功能结果。结果：9 名患者年龄为 12 岁或以下，15 名出现 16 处距骨骨折的患者年龄超过 12 岁。虽然12岁以下儿童的距骨骨折大多数属于Marti-Weber I型和II型骨折，但12岁以上的骨折患者中超过三分之二是Marti-Weber III型和IV型骨折。三分之二的 12 岁以下患者接受了非手术治疗，而只有 3 例青少年距骨骨折可以进行非手术治疗。儿童（< 12a）在随访（平均时间为3.2年；范围为治疗结束后7个月至8.4年）中未检测到坏死，而5名12岁以上的患者出现持续性坏死。结论：尽管导致距骨骨折的创伤原因没有明显差异，但与12岁以下儿童相比，青少年距骨骨折更为严重。此外，我们没有在12岁以下的患者中观察到持续性骨坏死，并且无论采用何种治疗方式，大多数病例的结果都是良好的。
Background: Fractures of the talus represent serious injuries of the foot skeleton. The most significant complications include osteonecrosis and posttraumatic malalignment with Subsequent arthritis. The aim of our study was to compare treatment and outcome of fractures of the talus between children and adolescents.Methods: From 1990 to 2005, 24 patients (18 male, 6 female) presented with 25 fractures of the talus. The medical records were reviewed retrospectively. Follow-up was performed by radiographical grading, and the functional outcome was measured using the Foot-Function-Index.Results: Nine patients were 12 years of age or younger, and 15 patients presenting 16 talar fractures were older than 12 years. Although most fractures of the talus in children younger than 12 years were classified as Marti-Weber type I and II fractures, more than two thirds of the fractures ill patients older than 12 years were Marti-Weber type III and IV fractures. Two thirds of the patients younger than 12 years were treated nonoperatively, whereas nonoperative treatment was possible in only three talar fractures in adolescents. No necrosis at follow-up (mean period, 3.2 years; range, 7 months to 8.4 years after end of treatment) was detected in children (< 12a), whereas five patients older than 12 years developed persisting necrosis.Conclusion: Even though there is no apparent difference in the cause of the trauma leading to fractures of the talus, adolescents present with more severe fractures of the talus compared with children younger than 12 years. In addition, we did not observe persistent osteonecrosis in patients younger than 12 years old, and the outcome is favorable in most cases irrespective of the mode of treatment.