[目的]探讨切开复位可吸收钉固定治疗儿童胫骨远端骨骺损伤的疗效。[方法]回顾分析本院2006年1月~2011年12月采取切开复位可吸收螺钉固定方法治疗的胫骨远端骨骺损伤患儿37例,其中15例获得随访;手术年龄5~15岁,平均12岁,其中男11例,女4例;左侧11例,右侧4例。按Salter-Harris骨骺损伤分型:Ⅱ型7例,Ⅲ型4例(包括1例Tillaux骨折),Ⅳ型2例,三平面骨折2例。所有患儿随访14~75个月,平均36.1个月。手术在C型臂X线机透视下进行,切开复位达到解剖复位后可吸收螺钉固定。术后石膏托固定6~8周。以改良Weber评估标准评价踝关节功能及愈合情况;拍摄双下肢全长正位、双踝关节正侧位X线片,评估切开复位可吸收钉治疗儿童胫骨远端骨骺损伤的疗效。[结果]本研究所有患侧与健侧下肢影像学分析结果显示:下肢机械轴与水平线成角,胫骨长度健侧与患侧比较差异有统计学意义(P<0.05)。而正侧位踝穴角患侧与健侧比较差异无统计学意义(P>0.05)。对获得随访的15例按改良Weber评分,优13例,良2例。所有患儿踝关节活动均不受限,均能参加正常的体育活动。X线片检查所有病例均骨性愈合,其中2例发生骨骺早闭,有骨桥形成,踝关节内翻畸形,肢体短缩并伴有下肢机械轴线的偏移。[结论]可吸收钉对胫骨远端骨骺损伤的固定可靠,对骨折愈合和踝关节功能恢复而言,具有良好的效果。 [Objective] To investigate the curative effect of open reduction and absorbable nail in the treatment of distal tibial epiphyseal injury in children. [Methods] A retrospective analysis of 37 patients with distal tibial epiphyseal injury treated by open reduction and absorbable screw fixation in our hospital from January 2006 to December 2011, of which 15 were followed up. The operative age ranged from 5 to 15 years. Average 12 years old, including 11 males and 4 females; left 11 cases, right 4 cases. According to Salter-Harris epiphyseal injury, there were 7 cases of type Ⅱ, 4 cases of type Ⅲ (including 1 case of Tillaux fracture), 2 cases of type Ⅳ and 2 cases of triplane fracture. All children were followed up 14 to 75 months, an average of 36.1 months. Surgery in the C-arm X-ray machine under fluoroscopy, open reduction after anatomic reduction can absorb screw fixation. Postoperative plaster fixed 6 to 8 weeks. The ankle joint function and healing condition were evaluated with the improved Weber evaluation criteria. The full-length lower extremity and lateral ankle joint radiographs were taken to evaluate the curative effect of open reduction and absorbable nail in the treatment of distal tibial epiphyseal injury in children. [Results] The imaging analysis results of all ipsilateral and contralateral lower extremities in this study showed that the mechanical axis of the lower limb was angulated with the horizontal line, and the difference between the contralateral tibia length and the affected side was statistically significant (P <0.05). There was no significant difference between the affected side and the contralateral side of ankle angle (P> 0.05). Fifteen patients were followed up according to the modified Weber score, excellent in 13 cases and good in 2 cases. All children with ankle activity are not limited, can participate in normal physical activity. X-ray examination of all cases were bony healing, including 2 cases of epiphyseal premature closure, bone bridge formation, ankle deformity, limb shortening accompanied by lower extremity mechanical axis offset. [Conclusion] The absorbable nail is reliable for the distal epiphyseal injury of the tibia and has a good effect on fracture healing and ankle joint function recovery.