Objective

To compare the mid-term clinical results of lag screw and Kirschner wire fixation(KWF) for close reduction in triplane distal tibia epiphyseal fracture.

Methods

A retrospective analysis of 25 cases of triplane fractures of the distal tibia treated in our department from Jan 2017 to Dec 2019 was performed, Lag screw fixation(LSF) was used in 14 cases and Kirschner wire fixation in 11 cases, the clinical results were evaluated by premature epiphyseal closure(PPC) rate, the American Orthopaedic Foot and Ankle Score (AOFAS) Ankle-hindfoot foot scoring system, the lateral distal tibial angle (LDTA) from X-ray.

Results

All the 25 children were followed up for a mean of 34(ranging 26–52) months. AOFAS scores improved from a mean of 33(ranging 29–43) pre-op, to 82(ranging 77–88) at three month follow up, to 92 (ranging 88–98) at last follow-up in all 25 cases. Till last follow up there was no cases premature physeal closure in LSF group but 4 cases in KWF group, LDTA in both groups at last follow up shows no ankle varus or valgus deformity, and the ankle joint function was not limited in all cases.

Conclusion

Lag screw and Kirschner wire fixation methods can both achieve good clinical effects for triplane distal tibia epiphyseal fracture. Lag screw fixation provide lower PPC rate but Kirschner wire fixation save one anesthesia and surgery.

中文翻译：

---

青少年三平面胫骨远端骨骺骨折闭合复位拉力螺钉固定与克氏针固定的中期临床疗效比较

客观的

比较拉力螺钉与克氏针内固定（KWF）闭合复位胫骨远端骨骺骨折三平面的中期临床疗效。

方法

回顾性分析2017年1月至2019年12月我科收治的25例胫骨远端三平面骨折，其中14例采用拉力螺钉固定（LSF），11例采用克氏针固定，评价临床疗效通过骨骺过早闭合（PPC）率，美国骨科足踝评分（AOFAS）踝 - 后足评分系统，来自X射线的外侧远端胫骨角（LDTA）。

结果

所有 25 名儿童的平均随访时间为 34（26-52 个月）。在所有 25 个病例中，AOFAS 评分从术前平均 33（范围 29-43）提高到三个月随访时的 82（范围 77-88），最后一次随访时提高到 92（范围 88-98）。至末次随访LSF组无骨骺过早闭合，KWF组4例，末次随访LDTA均未见踝关节内翻或外翻畸形，所有病例踝关节功能均未受限。

结论

拉力螺钉和克氏针固定方法治疗胫骨远端骨骺骨折均能取得良好的临床效果。拉力螺钉固定提供较低的 PPC 率，但克氏针固定可节省一次麻醉和手术。