METHODS: Children younger than 18 years from two urban tertiary care centers who underwent operative management of distal tibia Salter-Harris III and IV fractures using epiphyseal screws (2013-2020) were divided into two cohorts: retained epiphyseal screws and implant removed. Demographics, intraoperative, postoperative, and radiographic data were collected. Patient-reported outcomes (PROs) using the Foot and Ankle Ability Measure (FAAM) and Single Assessment Numeric Evaluation (SANE) questionnaires were collected at the final follow-up. Statistical analysis, including power analysis, was performed.
RESULTS: Fifty-two children were included (30 males, 22 females) with a mean age of 13.3 years at the time of injury (range, 7.7-16.4 years). Thirty-five children retained the implants; seventeen had implants removed. All completed the FAAM questionnaires at a mean follow-up of 4.4 ± 1.9 years, while 29 completed the SANE questionnaire at a mean follow-up of 4.4 ± 1.7 years. No statistically significant difference in patient demographics, surgical variables, or PROs was observed. Six children experienced complications from the initial surgery, including infections and complex regional pain syndrome, with no difference in complication rates between the cohorts ( P =0.08). Furthermore, no complication was observed as a result of implant removal.
CONCLUSIONS: Children with retained epiphyseal implants have similar functional outcomes as compared with those who had implants removed after distal tibial epiphyseal fracture fixation and union.
METHODS: Level III-Retrospective comparative study.
方法:来自两个城市三级护理中心的18岁以下儿童接受了胫骨远端Salter-HarrisIII和IV骨折的手术治疗(2013-2020年)。人口统计,术中,术后,并收集射线照相数据。在最后的随访中收集使用足踝能力测量(FAAM)和单一评估数字评估(SANE)问卷的患者报告结果(PRO)。统计分析,包括功率分析,已执行。
结果:包括52名儿童(30名男性,22名女性),受伤时平均年龄为13.3岁(范围,7.7-16.4年)。35名儿童保留了植入物;17名儿童移除了植入物。所有人都完成了FAAM问卷,平均随访时间为4.4±1.9年,29人完成了SANE问卷,平均随访4.4±1.7年。患者人口统计学无统计学差异,手术变量,或观察到PROs。六个孩子从最初的手术中经历了并发症,包括感染和复杂的区域疼痛综合征,两组间并发症发生率无差异(P=0.08)。此外,未观察到植入物移除导致的并发症.
结论:与胫骨远端骨phy骨折固定和愈合后取出植入物的儿童相比,保留骨phy植入物的儿童具有相似的功能结局。
方法:III级回顾性比较研究。