• 四川大學華西醫(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展進行綜述。

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展. 華西醫(yī)學, 2012, 27(3): 471-474. doi: 復制

1. 　胥少汀, 葛寶豐, 徐印坎. 實用骨科學[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診斷的進展[J]. 中華放射學雜志, 2001, 35(11): 867-869.
6. 　李衛(wèi)東, 牟秀川, 張智濤, 等. 兒童肱骨遠端骨骺損傷X線診斷與鑒別診斷(附182例分析)[J]. 濱州醫(yī)學院學報, 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值[J]. 中國超聲醫(yī)學雜志, 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, 郭源, 呂學敏. MRI在兒童骨骺損傷中的應用研究與進展[J]. 中華放射學雜志, 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驗研究[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生長板缺損的實驗研究[J]. 創(chuàng)傷外科雜志, 2002, 4(1): 16-19.
30. 　周強, 李起鴻, 戴剛. 骺板軟骨細胞復合三維支架體外構建組織工程軟骨的研究[J]. 中國修復重建外科雜志, 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. 動脈藥物灌注治療股骨頭骨骺無菌性壞死及治療前后動脈造影壓力測定比較分析[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. 實用骨科學[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診斷的進展[J]. 中華放射學雜志, 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)學院學報, 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值[J]. 中國超聲醫(yī)學雜志, 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, 郭源, 呂學敏. MRI在兒童骨骺損傷中的應用研究與進展[J]. 中華放射學雜志, 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驗研究[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生長板缺損的實驗研究[J]. 創(chuàng)傷外科雜志, 2002, 4(1): 16-19.
  30. 30. 　周強, 李起鴻, 戴剛. 骺板軟骨細胞復合三維支架體外構建組織工程軟骨的研究[J]. 中國修復重建外科雜志, 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. 動脈藥物灌注治療股骨頭骨骺無菌性壞死及治療前后動脈造影壓力測定比較分析[J].中國矯形外科雜志, 2000, 7(11): 1059-1062.