• 四川大學(xué)華西醫(yī)院小兒外科（成都，610041）;

兒童骨折中可能涉及骨骺及骺板損傷，骺板損傷可導(dǎo)致骨骺與干骺端之間形成骨橋，骺板提前閉合，造成肢體短縮和（或）成角畸形，影響兒童生長發(fā)育。骨骺及骺板損傷的早期診斷和治療仍是小兒矯形外科的難題?，F(xiàn)有的診斷方法和治療方法眾多，但都不甚滿意，現(xiàn)就兒童骨骺及骺板損傷的診斷和治療進(jìn)展進(jìn)行綜述。

引用本文： 楊健,劉少峰,劉敏. 兒童骨骺及骺板損傷的診斷和治療進(jìn)展. 華西醫(yī)學(xué), 2012, 27(3): 471-474. doi: 復(fù)制

版權(quán)信息： ?四川大學(xué)華西醫(yī)院華西期刊社《華西醫(yī)學(xué)》版權(quán)所有，未經(jīng)授權(quán)不得轉(zhuǎn)載、改編

1. 　胥少汀, 葛寶豐, 徐印坎. 實(shí)用骨科學(xué)[M]. 3版. 北京: 人民軍醫(yī)出版社, 1999: 917-921.
2. 　Wengev DR, Pring ME. Rang小兒骨折[M]. 3版. 潘少川, 主譯. 北京: 人民衛(wèi)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. 　屈輝. 兒童骺軟骨骨折影像學(xué)診斷的進(jìn)展[J]. 中華放射學(xué)雜志, 2001, 35(11): 867-869.
6. 　李衛(wèi)東, 牟秀川, 張智濤, 等. 兒童肱骨遠(yuǎn)端骨骺損傷X線診斷與鑒別診斷(附182例分析)[J]. 濱州醫(yī)學(xué)院學(xué)報(bào), 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. 　張敬東, 彭明惺, 劉利君, 等. 兒童肘部骨骺的超聲解剖及臨床價(jià)值[J]. 中國超聲醫(yī)學(xué)雜志, 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. 　張宜遠(yuǎn), 郭源, 呂學(xué)敏. MRI在兒童骨骺損傷中的應(yīng)用研究與進(jìn)展[J]. 中華放射學(xué)雜志, 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. 骺板損傷的診斷與治療的新進(jìn)展[J]. 臨床小兒外科雜志, 2003, 2(2): 115-119.
20. 　張愛明, 蔡林. 骺板損傷的診斷與治療進(jìn)展[J]. 中華創(chuàng)傷骨科雜志, 2003, 5(4): 365-367.
21. 　王恩波, 趙群, 馬瑞雪, 等. 不同自體移植物防止骺板損傷后骨橋形成的實(shí)驗(yàn)研究[J]. 中華小兒外科雜志, 2001, 22(4): 235-237.
22. 　田永軍, 胡斌, 石衛(wèi)華, 等. 骺板損傷部分早閉的治療研究進(jìn)展[J]. 中醫(yī)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. 　馬瑞雪, 吉士俊, 陳秋, 等. 骨橋切除、脂肪填塞, 截骨矯正治療小兒骨骺早閉的臨床觀察[J]. 中華小兒外科雜志, 2001, 22(2): 73-75.
27. 　郝國榮, 顧章平. 骺板骨橋切除后骺板恢復(fù)開放的X線觀察[J]. 中華小兒外科雜志, 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, 楊志明, 解慧琪, 等. 培養(yǎng)軟骨、肌肉和骨蠟移植修復(fù)生長板缺損的實(shí)驗(yàn)研究[J]. 創(chuàng)傷外科雜志, 2002, 4(1): 16-19.
30. 　周強(qiáng), 李起鴻, 戴剛. 骺板軟骨細(xì)胞復(fù)合三維支架體外構(gòu)建組織工程軟骨的研究[J]. 中國修復(fù)重建外科雜志, 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, 張平, 于立松, 等. 動(dòng)脈藥物灌注治療股骨頭骨骺無菌性壞死及治療前后動(dòng)脈造影壓力測(cè)定比較分析[J].中國矯形外科雜志, 2000, 7(11): 1059-1062.
  1. 1. 　胥少汀, 葛寶豐, 徐印坎. 實(shí)用骨科學(xué)[M]. 3版. 北京: 人民軍醫(yī)出版社, 1999: 917-921.
  2. 2. 　Wengev DR, Pring ME. Rang小兒骨折[M]. 3版. 潘少川, 主譯. 北京: 人民衛(wèi)生出版社, 2006: 9-19.
  3. 3. 　Ogden JA. Injury to growth mechanisms of the immature skeleton[J]. Skeletal Radiol, 1981, 6(4): 237-253.
  4. 4. 　Peterson HA. Physeal fractures: Part 3. Classification[J]. J Pediatr Orthop, 1994, 14(4): 439-448.
  5. 5. 　屈輝. 兒童骺軟骨骨折影像學(xué)診斷的進(jìn)展[J]. 中華放射學(xué)雜志, 2001, 35(11): 867-869.
  6. 6. 　李衛(wèi)東, 牟秀川, 張智濤, 等. 兒童肱骨遠(yuǎn)端骨骺損傷X線診斷與鑒別診斷(附182例分析)[J]. 濱州醫(yī)學(xué)院學(xué)報(bào), 2008, 31(1): 78-80.
  7. 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. 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. 9. 　張敬東, 彭明惺, 劉利君, 等. 兒童肘部骨骺的超聲解剖及臨床價(jià)值[J]. 中國超聲醫(yī)學(xué)雜志, 2003, 19(6): 455-458.
  10. 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. 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. 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. 13. 　張宜遠(yuǎn), 郭源, 呂學(xué)敏. MRI在兒童骨骺損傷中的應(yīng)用研究與進(jìn)展[J]. 中華放射學(xué)雜志, 2009, 43(4): 446-448.
  14. 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. 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. 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. 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. 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. 19. 　詹新立, 周江南. 骺板損傷的診斷與治療的新進(jìn)展[J]. 臨床小兒外科雜志, 2003, 2(2): 115-119.
  20. 20. 　張愛明, 蔡林. 骺板損傷的診斷與治療進(jìn)展[J]. 中華創(chuàng)傷骨科雜志, 2003, 5(4): 365-367.
  21. 21. 　王恩波, 趙群, 馬瑞雪, 等. 不同自體移植物防止骺板損傷后骨橋形成的實(shí)驗(yàn)研究[J]. 中華小兒外科雜志, 2001, 22(4): 235-237.
  22. 22. 　田永軍, 胡斌, 石衛(wèi)華, 等. 骺板損傷部分早閉的治療研究進(jìn)展[J]. 中醫(yī)正骨, 2005, 17(1): 58-59.
  23. 23. 　Langenskiold A.Surgical of partial partial closure of growth plate[J]. Pedoatr Orthop, 1981, 1(1): 3-11.
  24. 24. 　Peterson HA. Partial growth arrest and its treatment[J]. J Pediatr Orthop, 1984, 4(2): 246-258.
  25. 25. 　Bright TW. Partial growth arrest: identification,classification and results of treatment[J]. Orthop Trans, 1982, 6: 65-66.
  26. 26. 　馬瑞雪, 吉士俊, 陳秋, 等. 骨橋切除、脂肪填塞, 截骨矯正治療小兒骨骺早閉的臨床觀察[J]. 中華小兒外科雜志, 2001, 22(2): 73-75.
  27. 27. 　郝國榮, 顧章平. 骺板骨橋切除后骺板恢復(fù)開放的X線觀察[J]. 中華小兒外科雜志, 2000, 21(4): 235-237.
  28. 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. 29. 　王建, 楊志明, 解慧琪, 等. 培養(yǎng)軟骨、肌肉和骨蠟移植修復(fù)生長板缺損的實(shí)驗(yàn)研究[J]. 創(chuàng)傷外科雜志, 2002, 4(1): 16-19.
  30. 30. 　周強(qiáng), 李起鴻, 戴剛. 骺板軟骨細(xì)胞復(fù)合三維支架體外構(gòu)建組織工程軟骨的研究[J]. 中國修復(fù)重建外科雜志, 2004, 18(2): 92-95.
  31. 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. 32. 　Johnstone B, Yoo JU. Autologous mesenchymal progenitor cells in articular cartilage repair[J]. Clin Orthop Relat Res, 1999 (367 Suppl): 156-162.
  33. 33. 　Bowen JR, Johnson WJ. Percutaneous epiphysiodesis[J]. Clin Orthop Relat Res, 1984 (190): 170-173.
  34. 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. 35. 　Ilizarov GA. Clinical application of the tension-stress effect for limb lengthening[J]. Clin Orthop Relat Res, 1990 (250): 8-26.
  36. 36. 　宋培德, 張平, 于立松, 等. 動(dòng)脈藥物灌注治療股骨頭骨骺無菌性壞死及治療前后動(dòng)脈造影壓力測(cè)定比較分析[J].中國矯形外科雜志, 2000, 7(11): 1059-1062.