青少年胫骨远端三平面骨折的诊疗进展

Progress in Diagnosis and Treatment of Triplane Fracture of Distal Tibia in Adolescents

摘要: 胫骨远端三平面骨折是一种青少年常见的复杂骨折，主要发生在骨骺板闭合的过渡期。随着影像技术的进步，尤其是CT的广泛应用，骨折的精确分型和手术规划得到了显著改善。传统上，三平面骨折的治疗策略包括保守治疗和手术治疗，取决于骨折移位的程度。近年来的研究表明，精确的解剖复位和稳定的内固定对恢复关节功能至关重要。手术复位不佳可能导致关节功能障碍及骨骺早闭等并发症。术后康复管理包括早期的关节活动度训练和逐渐的负重训练也至关重要，旨在减少关节僵硬和功能丧失。最新文献表明，尽管手术治疗能取得较好的预后，但仍需长时间随访以评估远期关节炎及骨骼生长的潜在问题。

Abstract: Triplane fracture of distal tibia is a common complex fracture in adolescents, which mainly occurs in the transition period of epiphyseal plate closure. With the progress of imaging technology, especially the wide application of CT, the accurate classification and surgical planning of fractures have been significantly improved. Traditionally, the treatment strategies of triplane fractures include conservative treatment and surgical treatment, depending on the degree of fracture displacement. Recent studies have shown that accurate anatomical reduction and stable internal fixation are essential to restore joint function. Poor surgical reduction may lead to joint dysfunction and epiphyseal closure and other complications. Postoperative rehabilitation management, including early joint mobility training and gradual weight-bearing training, is also crucial, aiming to reduce joint stiffness and loss of function. The latest literature shows that although surgical treatment can achieve a better prognosis, long-term follow-up is still needed to evaluate the potential problems of long-term arthritis and bone growth.