Wang Yixin,Wang Bo,Zhang Zhiqun,et al.Clinical characteristics and efficacies of tibial tuberosity avulsion fractures in adolescents of differential body mass index[J].Journal of Clinical Pediatric Surgery,,():1037-1041.[doi:10.3760/cma.j.cn101785-202210057-008]
Clinical characteristics and efficacies of tibial tuberosity avulsion fractures in adolescents of differential body mass index
- Abstract:
- Objective To explore the clinical characteristics and efficacies of tibial tuberosity avulsion fractures in adolescents of differential body mass index (BMI). Methods A retrospective analysis was performed for 30 children (33 knees) with tibial tubercle avulsion fractures from January 2017 to February 2018.According to Chinese standards of adolescent overweight and obesity screening,they were assigned by gender age group BMI into large weight group (n=20) and normal weight group (n=10).Two cases (2 knees) were managed conservatively with manipulative repositioning and anterioposterior plaster brace fixation in extended knee position.Another 28 cases (31 knees) were operated with incisional reduction and internal fixation.Modified Odgen method was employed for staging and comparing two groups in terms of intraoperative volume of hemorrhage,operative duration,time to return to daily activities,time to return to weight-bearing activities and Mosier knee function assessment at the last follow-up. Results No statistically significant inter-group difference existed in age,gender,sideness of injury or mechanism of injury (P>0.05).However,major reorganization was more prone to type Ⅲ fracture than normal group[(18/20) vs.(3/10)]and more likely to be complicated with peripheral ligament injuries[(3/10) vs.(15/20)].There were statistically significant differences (P<0.05).Operative duration[(115.75±63.81) vs.(75.63±27.44) min]and intraoperative volume of hemorrhage[(83.75±84.69) vs.(20.63±17.81) mL]spiked markedly in major group than those of normal group.There were statistically significant differences (P<0.05).During regular follow-ups,the difference was not statistically significant in the degree of functional knee activity at the last follow-up (P>0.05).However,time for resuming physical activity was longer in major group than that in normal group[(5.75±1.52) vs.(4.19±0.92) month],P<0.05). Conclusions More common in large-weight adolescents with tibial tuberosity avulsion fractures,type III fractures are more likely to be associated with ligamentous injuries.With intraoperative volume of hemorrhage,operative duration is longer and there is an extended return to weight-bearing activities.However,long-term prognostic outcomes are not affected.
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Memo
收稿日期:2022-10-26。
基金项目:南京市卫生科技发展专项资金资助项目(YKK22172)
通讯作者:董展,Email:dongzhan121@163.com