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目的 通过对胫骨远端三平面骨折患儿的临床资料分析 ,探讨其致伤机制中的生物力学因素。方法 收集威尔士亲王医院骨科 1997年 8月至 2 0 0 2年 10月间三平面骨折患儿临床资料17例 ,男 15例 ,女 2例 ,年龄为 12～ 16岁 ,左侧 11例 ,右侧 6例 ,依据不同分型方法进行分类。回顾伤足损伤时的姿态 ,并通过三维CT观察远端骨折片的移位情况。结果 外侧型、二部分型、Ⅰ型分别占 10 0 %、88.2 %、70 .6 % ;伤足损伤时含有内翻、跖屈因素的分别占 82 .3%、4 7.1% ;远端骨折片的移位情况中有外旋、内翻、跖屈表现的分别占 10 0 %、5 0 .0 %、71.4 %。结论 ①外侧型、二部分型、Ⅰ型是较为常见的三平面骨折形式 ;②踝关节过度内翻、跖屈以及近端外旋可能为导致三平面骨折的主要因素 ;③提出“三平面复位”概念试行闭合复位。
Objective To analyze the clinical data of children with tibial three-plane fractures and to explore the biomechanical factors in their injury mechanism. Methods The data of 17 children with triple plane fracture in Prince of Wales Hospital from August 1997 to October 2002 were collected. There were 15 males and 2 females, aged from 12 to 16 years old, with 11 left and right 6 cases, according to different classification methods for classification. Reviewing the posture of injured foot injury, and through the three-dimensional CT observation distal fracture plate displacement. Results The lateral type, two-part type and type Ⅰ accounted for 100%, 88.2% and 70.6%, respectively. The injuries of the instep and the plantar flexion were 82.3% and 41.7% The displacement of the film in a rotation, varus, plantar flexion performance accounted for 10 0%, 50%, 71.4%. Conclusions ① The lateral type and the two-part type are the most common forms of tri-plane fractures. ② The ankle over pronation, plantar flexion and proximal pronation may be the main factors leading to tri-plane fractures. Concept trial closed reset.