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目的 探讨一种新的儿童先天性胫骨假关节的X线分型,为临床治疗和判断预后提供依据.方法 回顾性分析本单位2004年至2014年期间收治的171例先天性胫骨假关节患儿的X线片,男125例(73％),女46例(27％),手术时平均年龄42.5个月.胫骨X线表现包括以下四种情况:Ⅰ型,胫骨前弓,在畸形的顶点处骨皮质增厚、但骨髓腔正常;Ⅱ型,胫骨前弓,在畸形的顶点处髓腔狭窄、骨皮质增厚和骨小梁的缺失;Ⅲ型,胫骨囊性病变,可以发生在胫骨的任何部位;Ⅳ型,胫骨假关节.腓骨X线表现包括以下四种情况:a:腓骨发育正常;b:腓骨发育不良(腓骨直径小于健侧腓骨直径);c:腓骨囊性变,多数发生在腓骨下1/3;d:腓骨假关节.根据患儿就诊时胫骨和腓骨的X线表现,提出一种新的X线分型方法.无论患儿是否曾经历手术治疗、是否有内外固定.结果 171例儿童先天性胫骨假关节按新的X线分型方法,不同类型的病例数如下:Ⅰa型9例,Ⅰb型3例,Ⅰc型3例,Ⅰd型4例.Ⅱa型9例,Ⅱb型15例,Ⅱc型3例,Ⅱd型6例.Ⅲa型6例,Ⅲb型12例,Ⅲc型8例,Ⅲd型17例.Ⅳa型13例,Ⅳb型10例,Ⅳc型4例,Ⅳd型49例.结论 结合儿童先天性胫骨假关节的胫骨和腓骨的X线表现、提出的这种新的X线分型方法,能够囊括目前本单位所有的病例.有可能为先天性胫骨假关节的治疗、术后并发症的防治、预后判断提供重要的指导作用,但仍有待进一步研究.“,”Objective To establish a new x-ray classification scheme of congenital pseudarthrosis of the tibia (CPT) for providing rationales for its management and prognostic assessment.Methods For this retrospective study, the radiographic films of 171 CPT patients between 2004 and 2014 were analyzed.There were 125 boys (73％) and 46 girls (27％) with an average operative age of 42.5 months.The radiographic findings included the following four conditions : type Ⅰ was defined by anterior bow of the tibia, cortical thickening at the apex of deformity yet marrow cavity was normal;type Ⅱ showed anterior tibial bow, cortical thickening, trabeculation defect and canal stenosis at the apex of deformity;type Ⅲ was manifested as a cystic lesion occurring in any part of tibia;type Ⅳ, pseudarthrosis of tibia.Fibula radiographic characteristics included the following four conditions: a, normal-appearing fibula;b, fibula dysplasia (diameter of fibula ＜ diameter of normal contralateral fibula);c, fibula cystic degeneration;d, fibula pseudarthrosis.A new radiographic classification of CPT was formulated according to the radiographic features of tibia and fibula.It was independent of patient status of surgery or external/internal fixation.Results There were 171 CPT cases under the new radiographic classification scheme.The cases of each type were Ⅰ a (n=9), Ⅰ b (n=3), Ⅰ c (n=3), Ⅰ d (n=4), Ⅱa (n-9), Ⅱb (n=15), Ⅱc (n=3), Ⅱd (n=6), Ⅲ a (n=6), Ⅲb (n=12), Ⅲc (n=8), Ⅲd (n=17), Ⅳa (n=13), Ⅳb (n=10), Ⅳc (n=4) and Ⅳd (n =49).Conclusions The new radiologic classification scheme of CPT has considered the radiographic features of tibia and fibula.All our institutional cases are accounted for.And such a new scheme may play a key role in the diagnosis and management of postoperative complications for CPT.Further studies are warranted.