| PurposeTo summarize the epidemiological characteristics children Salter-Harris type Ⅱ of epiphyseal fracture of distal radius,and analyze the residual the maximum acceptable Growth Plate-Shaft(GP-S)angle and degree of shift after manual reduction treatment.To compare the advantages of manual reduction and surgical treatment.MethodsCollected the 201 patients diagnosed Salter-Harris type Ⅱ of epiphyseal fracture of distal radius and visited Fuzhou Second Hospital Affiliated to Xiamen University from January 2015 to January 2020.Recorded the age,gender,side,displacement of the distal direction at the time of injury,degree of residual angulation and lateral displacement before and after treatment and during fracture healing,Gartland-Werley wrist score and complications.According to the treatment methods,they were divided into manual reduction group(110 cases)and operation group(91 cases).The manual reduction group was reduced by eight methods of bone setting and then fixed by casting.The operation group was treated with closed reduction with Kirschner wire internal fixation.Summarized the epidemiological characteristics children Salter-Harris type Ⅱ of epiphyseal fracture of distal radius,analyzed the residual the maximum acceptable GP-S angle and degree of shift after manual reduction treatment,and compared the advantages of manual reduction and surgical treatment for treating children the Salter-Harris type Ⅱ of epiphyseal fracture of distal radius.Results1.The Salter-Harris type Ⅱ of epiphyseal fracture of distal radius most happens at 7-16 years old young people.The male to female ratio is 5.7:1.The mean age of males was 11.99 years old(7-17 years old)and the peak age was 12 years old.The mean age of females was10.07 years old(7-15 years old)and the peak age was 10 years old.The difference was statistically significant(P>0.05).139 cases were involved on the left side(67.48%)and 67 cases on the right side(32.52%).155 cases of dorsal displacement(75.24%)and 51 cases of volar displacement(24.76%).2.When the fixation was removed,the relative degree of displacement and GP-S angle formation on lateral radiographs and the GP-S angle formation on anteroposterior radiographs were significantly different between the two groups,and the operation group was better than the manual reduction group(P<0.05).Compared with operation group,the incidence of redisplacement with manual reduction group was 3.40%,but there were no complications such as epiphyseal closed early and carpal deformity.There was no statistically significant difference in Gartland-Werley scores between the two groups at the last follow-up(P>0.05).The results of Gartland-Werley score in the manual reduction group were excellent in 108 cases,good in 2cases and poor in 1 case,in the operation group,there were 93 excellent cases,1 good case and1 poor case.There was no statistically significant difference in Gartland-Werley scores between the two groups(P>0.05).3.The 95% reference range of manual reduction with casting fixation for Salter-Harris type Ⅱ of epiphyseal fracture of distal radius was 15.9% of the shift and 81.70-101.42° dorsal distal GP-S angle on the lateral position,6.69% of the shift and 83.67-94.40° distal ulnar GPS angle on the anteroposterior position.In this case,good results can be obtained.Conclusions1.In this reseach Salter-Harris type Ⅱ of epiphyseal fracture of distal radius occur more frequently in 7-16 years of age.The incidence is higher in male than in female,with dorsal displacement than volar displacement and are more common in the left hand.The peak age of Salter-Harris type Ⅱ of epiphyseal fracture of distal radius is earlier in female than in male.2.Manual reduction with casting fixation for Salter-Harris type Ⅱ of epiphyseal fracture of distal radius maximumly accept 15.9% of the shift and 81.70-101.42°dorsal distal GP-S angle on the lateral position,6.69% of the shift and 83.67-94.40°distal ulnar GP-S Angle on the anteroposterior position.There are no complications such as epiphyseal closed early,so there is no need to force anatomical reduction.3.Both manual reduction with casting fixation and internal fixation with Kirschner wire can achieve satisfactory wrist function,and the two methods have their own advantages. |
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