18P四体综合征患儿开放性创伤性股骨远端生长板骨折

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背景。开放性股骨远端生长板骨折是一种比较罕见的损伤,因为只有强大的外力才会导致此类骨折。对于儿科患儿,生长板损伤、后续生长障碍和损伤后畸形的风险会增加,因此对该类损伤给予合理的诊治至关重要。患儿骨折也可能导致遗传性综合征(特别是结缔组织疾病)、营养异常或容易造成异常骨骼矿物质密度的疾病等后遗症。

病例报告。我们报道了一例9岁18p四体综合征女性患儿,该患儿下肢创伤后出现严重移位的右侧开放性股骨远端生长板骨折。行冲洗和清创术,然后经股骨远端骨骺行开放复位和钢针交叉固定。术后,患肢石膏固定未承重4周,6周后取出钢针。在为期6个月的随访中,患儿活动度完全恢复,并康复至伤前水平,学校生活无障碍。

讨论。18p四体综合征导致先天肌肉无力,可干扰固定长骨肌肉的正常软组织肌腱,可导致创伤时骨折部位发生更大位移,因此血管损伤、生长板损伤和整体预后较差的几率更高。临床医生必须熟悉18p四体综合征及其相关骨科表现。

结论。研究18p四体综合征患儿骨折诊治的文献很少。我们报告了术前和术后使用抗生素、冲洗和
清创、开放性骨折固定和术后固定的护理标准,效果良好。我们还将非负重时间延长了1周,且钢针取出时间比无骨骼或结缔组织疾病患儿晚1周。

作者简介

Abdul Rehman Arain

Albany Medical Center Department of Orthopaedic Surgery

编辑信件的主要联系方式.
Email: mrbonelover@gmail.com
ORCID iD: 0000-0001-6625-7675
http://www.amc.edu

MD, Orthopaedic Surgery Resident, Physician

美国, Albany, NY

Muhammad Moral

Albany Medical Center Department of Orthopaedic Surgery

Email: MoralM@amc.edu

MD, Orthopaedic Surgery Resident, Physician

美国, Albany, NY

Khusboo Desai

Albany Medical Center Department of Orthopaedic Surgery

Email: DesaiK@amc.edu

MD, Orthopaedic Surgery Resident, Physician

美国, Albany, NY

Curtis Adams

Albany Medical Center Department of Orthopaedic Surgery

Email: Adamsc@amc.edu

MD, Orthopaedic Surgery Resident, Physician

Albany, NY

Jared Roberts

Albany Medical Center Department of Orthopaedic Surgery

Email: Robertsj@amc.edu

MD, Orthopaedic Surgery Resident, Physician

俄罗斯联邦, Albany, NY

参考

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