儿童骨骺及骺板损伤的诊断和治疗进展_West China Medical Journal

Authors：

杨健 , 刘少峰 ,  刘敏

Corresponding author：

刘敏, Email: olos@163.com

Keywords：

儿童; 骺板损伤; 诊断; 治疗

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儿童骨折中可能涉及骨骺及骺板损伤，骺板损伤可导致骨骺与干骺端之间形成骨桥，骺板提前闭合，造成肢体短缩和（或）成角畸形，影响儿童生长发育。骨骺及骺板损伤的早期诊断和治疗仍是小儿矫形外科的难题。现有的诊断方法和治疗方法众多，但都不甚满意，现就儿童骨骺及骺板损伤的诊断和治疗进展进行综述。

Citation： 杨健,刘少峰,刘敏. 儿童骨骺及骺板损伤的诊断和治疗进展. West China Medical Journal, 2012, 27(3): 471-474. doi: Copy

1.	胥少汀, 葛宝丰, 徐印坎. 实用骨科学[M]. 3版. 北京: 人民军医出版社, 1999: 917-921.
2.	Wengev DR, Pring ME. Rang小儿骨折[M]. 3版. 潘少川, 主译. 北京: 人民卫生出版社, 2006: 9-19.
3.	Ogden JA. Injury to growth mechanisms of the immature skeleton[J]. Skeletal Radiol, 1981, 6(4): 237-253.
4.	Peterson HA. Physeal fractures: Part 3. Classification[J]. J Pediatr Orthop, 1994, 14(4): 439-448.
5.	屈辉. 儿童骺软骨骨折影像学诊断的进展[J]. 中华放射学杂志, 2001, 35(11): 867-869.
6.	李卫东, 牟秀川, 张智涛, 等. 儿童肱骨远端骨骺损伤X线诊断与鉴别诊断(附182例分析)[J]. 滨州医学院学报, 2008, 31(1): 78-80.
7.	Lemburg SP, Lilienthal E, Heyer CM. Growth plate fractures of the distal tibia: is CT imaging necessary?[J]. Arch Orthop Trauma Surg, 2010, 130(11): 1411-1417.
8.	Davidson RS, Markowitz RI, Dorrmaus J, et al. Ultrasonographic evaluation of the elbow in infants and young children after suspected trauma[J]. J Bone Joint Surg (Am), 1994, 76(12): 1804-1813.
9.	张敬东, 彭明惺, 刘利君, 等. 儿童肘部骨骺的超声解剖及临床价值[J]. 中国超声医学杂志, 2003, 19(6): 455-458.
10.	Markowitz RI, Davidson RS, Harty MP, et al. Sonography of the elbow in infants and children[J]. ARJ Am J Roentgenol, 1992, 159(4): 829-833.
11.	Bar-on E, Howard CB, Porat S. The use of ultrasound in the diagnosis of atypicalpathology in the unossified skeleton[J]. J Pediatr Orthop, 1995, 15(6): 817-820.
12.	Jaramillo D, Kammen BF, Shapiro F. Cartilaginous path of physeal fracture separations:evaluation with MR imaging:an experimental study with histologic corelation in rabbits[J]. Radiology, 2000, 215(2): 504-511.
13.	张宜远, 郭源, 吕学敏. MRI在儿童骨骺损伤中的应用研究与进展[J]. 中华放射学杂志, 2009, 43(4): 446-448.
14.	Craig JG, Cramer KE, Cody DD. Premature partial closure and other deformities of the growth plate: MR imaging and three-dimensional modeling[J]. Radiology, 1999, 210(3): 835-843.
15.	Futami T, Foster BK, Morris LL, et al. Magnetic resonance imaging of groth plate injurues: the efficacy and indications for surgical of procedures[J]. Arch Orthop Trauma Surg, 2000, 120(7-8): 390-396.
16.	Kim CW, Jaramillo D, Hresko MT. MRI demonstration of occult purely chondral fractures of the tibia: a potential mimic of meniscal tears[J]. Pediatr Radiol, 1997, 27(9): 765-766.
17.	Ecklund K, Jaramillo D. Patterns of premature arrest: MR imaging of 111 children[J]. AJR Am J Roentgenology, 2002, 178(4): 967-972.
18.	Sailhan F, Chotel F, Guibal AL, et al. Three-dimensional MR imaging in the assessment of physeal growth arrest[J]. Eur Radiol,2004, 14(9): 1600-1608.
19.	詹新立, 周江南. 骺板损伤的诊断与治疗的新进展[J]. 临床小儿外科杂志, 2003, 2(2): 115-119.
20.	张爱明, 蔡林. 骺板损伤的诊断与治疗进展[J]. 中华创伤骨科杂志, 2003, 5(4): 365-367.
21.	王恩波, 赵群, 马瑞雪, 等. 不同自体移植物防止骺板损伤后骨桥形成的实验研究[J]. 中华小儿外科杂志, 2001, 22(4): 235-237.
22.	田永军, 胡斌, 石卫华, 等. 骺板损伤部分早闭的治疗研究进展[J]. 中医正骨, 2005, 17(1): 58-59.
23.	Langenskiold A.Surgical of partial partial closure of growth plate[J]. Pedoatr Orthop, 1981, 1(1): 3-11.
24.	Peterson HA. Partial growth arrest and its treatment[J]. J Pediatr Orthop, 1984, 4(2): 246-258.
25.	Bright TW. Partial growth arrest: identification,classification and results of treatment[J]. Orthop Trans, 1982, 6: 65-66.
26.	马瑞雪, 吉士俊, 陈秋, 等. 骨桥切除、脂肪填塞, 截骨矫正治疗小儿骨骺早闭的临床观察[J]. 中华小儿外科杂志, 2001, 22(2): 73-75.
27.	郝国荣, 顾章平. 骺板骨桥切除后骺板恢复开放的X线观察[J]. 中华小儿外科杂志, 2000, 21(4): 235-237.
28.	Lee EH, Chen F, Chan JW. The effect of surgery on the iliac apophysis: an experimental study[J]. J Pediatr Orthop, 1998, 18(3): 406-409.
29.	王建, 杨志明, 解慧琪, 等. 培养软骨、肌肉和骨蜡移植修复生长板缺损的实验研究[J]. 创伤外科杂志, 2002, 4(1): 16-19.
30.	周强, 李起鸿, 戴刚. 骺板软骨细胞复合三维支架体外构建组织工程软骨的研究[J]. 中国修复重建外科杂志, 2004, 18(2): 92-95.
31.	Wakitani S, Goto T, Pineda SJ, et al. Mesenchymal cell-based repair of large, full-thickness defects of articular cartilage[J]. J Bone Joint Surg(Am), 1994, 76(4): 579-592.
32.	Johnstone B, Yoo JU. Autologous mesenchymal progenitor cells in articular cartilage repair[J]. Clin Orthop Relat Res, 1999 (367 Suppl): 156-162.
33.	Bowen JR, Johnson WJ. Percutaneous epiphysiodesis[J]. Clin Orthop Relat Res, 1984 (190): 170-173.
34.	Métaizeau JP, Wong-Chung J, Bertrand H, et al. Percutaneous epiphysiodesis using transphyseal screws (PETS) [J]. J Pediatr Orthop, 1998, 18(3): 363-369.
35.	Ilizarov GA. Clinical application of the tension-stress effect for limb lengthening[J]. Clin Orthop Relat Res, 1990 (250): 8-26.
36.	宋培德, 张平, 于立松, 等. 动脉药物灌注治疗股骨头骨骺无菌性坏死及治疗前后动脉造影压力测定比较分析[J].中国矫形外科杂志, 2000, 7(11): 1059-1062.

1. 　胥少汀, 葛宝丰, 徐印坎. 实用骨科学[M]. 3版. 北京: 人民军医出版社, 1999: 917-921.
2. 　Wengev DR, Pring ME. Rang小儿骨折[M]. 3版. 潘少川, 主译. 北京: 人民卫生出版社, 2006: 9-19.
3. 　Ogden JA. Injury to growth mechanisms of the immature skeleton[J]. Skeletal Radiol, 1981, 6(4): 237-253.
4. 　Peterson HA. Physeal fractures: Part 3. Classification[J]. J Pediatr Orthop, 1994, 14(4): 439-448.
5. 　屈辉. 儿童骺软骨骨折影像学诊断的进展[J]. 中华放射学杂志, 2001, 35(11): 867-869.
6. 　李卫东, 牟秀川, 张智涛, 等. 儿童肱骨远端骨骺损伤X线诊断与鉴别诊断(附182例分析)[J]. 滨州医学院学报, 2008, 31(1): 78-80.
7. 　Lemburg SP, Lilienthal E, Heyer CM. Growth plate fractures of the distal tibia: is CT imaging necessary?[J]. Arch Orthop Trauma Surg, 2010, 130(11): 1411-1417.
8. 　Davidson RS, Markowitz RI, Dorrmaus J, et al. Ultrasonographic evaluation of the elbow in infants and young children after suspected trauma[J]. J Bone Joint Surg (Am), 1994, 76(12): 1804-1813.
9. 　张敬东, 彭明惺, 刘利君, 等. 儿童肘部骨骺的超声解剖及临床价值[J]. 中国超声医学杂志, 2003, 19(6): 455-458.
10. 　Markowitz RI, Davidson RS, Harty MP, et al. Sonography of the elbow in infants and children[J]. ARJ Am J Roentgenol, 1992, 159(4): 829-833.
11. 　Bar-on E, Howard CB, Porat S. The use of ultrasound in the diagnosis of atypicalpathology in the unossified skeleton[J]. J Pediatr Orthop, 1995, 15(6): 817-820.
12. 　Jaramillo D, Kammen BF, Shapiro F. Cartilaginous path of physeal fracture separations:evaluation with MR imaging:an experimental study with histologic corelation in rabbits[J]. Radiology, 2000, 215(2): 504-511.
13. 　张宜远, 郭源, 吕学敏. MRI在儿童骨骺损伤中的应用研究与进展[J]. 中华放射学杂志, 2009, 43(4): 446-448.
14. 　Craig JG, Cramer KE, Cody DD. Premature partial closure and other deformities of the growth plate: MR imaging and three-dimensional modeling[J]. Radiology, 1999, 210(3): 835-843.
15. 　Futami T, Foster BK, Morris LL, et al. Magnetic resonance imaging of groth plate injurues: the efficacy and indications for surgical of procedures[J]. Arch Orthop Trauma Surg, 2000, 120(7-8): 390-396.
16. 　Kim CW, Jaramillo D, Hresko MT. MRI demonstration of occult purely chondral fractures of the tibia: a potential mimic of meniscal tears[J]. Pediatr Radiol, 1997, 27(9): 765-766.
17. 　Ecklund K, Jaramillo D. Patterns of premature arrest: MR imaging of 111 children[J]. AJR Am J Roentgenology, 2002, 178(4): 967-972.
18. 　Sailhan F, Chotel F, Guibal AL, et al. Three-dimensional MR imaging in the assessment of physeal growth arrest[J]. Eur Radiol,2004, 14(9): 1600-1608.
19. 　詹新立, 周江南. 骺板损伤的诊断与治疗的新进展[J]. 临床小儿外科杂志, 2003, 2(2): 115-119.
20. 　张爱明, 蔡林. 骺板损伤的诊断与治疗进展[J]. 中华创伤骨科杂志, 2003, 5(4): 365-367.
21. 　王恩波, 赵群, 马瑞雪, 等. 不同自体移植物防止骺板损伤后骨桥形成的实验研究[J]. 中华小儿外科杂志, 2001, 22(4): 235-237.
22. 　田永军, 胡斌, 石卫华, 等. 骺板损伤部分早闭的治疗研究进展[J]. 中医正骨, 2005, 17(1): 58-59.
23. 　Langenskiold A.Surgical of partial partial closure of growth plate[J]. Pedoatr Orthop, 1981, 1(1): 3-11.
24. 　Peterson HA. Partial growth arrest and its treatment[J]. J Pediatr Orthop, 1984, 4(2): 246-258.
25. 　Bright TW. Partial growth arrest: identification,classification and results of treatment[J]. Orthop Trans, 1982, 6: 65-66.
26. 　马瑞雪, 吉士俊, 陈秋, 等. 骨桥切除、脂肪填塞, 截骨矫正治疗小儿骨骺早闭的临床观察[J]. 中华小儿外科杂志, 2001, 22(2): 73-75.
27. 　郝国荣, 顾章平. 骺板骨桥切除后骺板恢复开放的X线观察[J]. 中华小儿外科杂志, 2000, 21(4): 235-237.
28. 　Lee EH, Chen F, Chan JW. The effect of surgery on the iliac apophysis: an experimental study[J]. J Pediatr Orthop, 1998, 18(3): 406-409.
29. 　王建, 杨志明, 解慧琪, 等. 培养软骨、肌肉和骨蜡移植修复生长板缺损的实验研究[J]. 创伤外科杂志, 2002, 4(1): 16-19.
30. 　周强, 李起鸿, 戴刚. 骺板软骨细胞复合三维支架体外构建组织工程软骨的研究[J]. 中国修复重建外科杂志, 2004, 18(2): 92-95.
31. 　Wakitani S, Goto T, Pineda SJ, et al. Mesenchymal cell-based repair of large, full-thickness defects of articular cartilage[J]. J Bone Joint Surg(Am), 1994, 76(4): 579-592.
32. 　Johnstone B, Yoo JU. Autologous mesenchymal progenitor cells in articular cartilage repair[J]. Clin Orthop Relat Res, 1999 (367 Suppl): 156-162.
33. 　Bowen JR, Johnson WJ. Percutaneous epiphysiodesis[J]. Clin Orthop Relat Res, 1984 (190): 170-173.
34. 　Métaizeau JP, Wong-Chung J, Bertrand H, et al. Percutaneous epiphysiodesis using transphyseal screws (PETS) [J]. J Pediatr Orthop, 1998, 18(3): 363-369.
35. 　Ilizarov GA. Clinical application of the tension-stress effect for limb lengthening[J]. Clin Orthop Relat Res, 1990 (250): 8-26.
36. 　宋培德, 张平, 于立松, 等. 动脉药物灌注治疗股骨头骨骺无菌性坏死及治疗前后动脉造影压力测定比较分析[J].中国矫形外科杂志, 2000, 7(11): 1059-1062.

West China Medical Journal

儿童骨骺及骺板损伤的诊断和治疗进展

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