Hackl W, Benedetto K P, Fink C, Sailer R, Rieger M
University Hospital Innsbruck, Department of Trauma Surgery, Austria.
Knee Surg Sports Traumatol Arthrosc. 1999;7(6):352-5. doi: 10.1007/s001670050179.
Irreducible patellar dislocations are rare injuries, but those that do occur are mainly directed intra-articularly. In this case, a 53-year-old woman sustained a locked lateral patellar dislocation when falling from a chair. A preoperative CT-scan revealed bony avulsions at the insertion of the vastus medialis muscle, the medical retinaculum, and partial disruption of the ligamentum patellae from the apex patellae. Open reduction was necessary and the torn structures were reattached with anchor systems and sutures. Postoperative management included intensive physiotherapy. At 1 year after surgery, the patient was without swelling or pain and had a normal gait, but flexion was restricted to 120 degrees. All postoperative radiographs showed the patella correctly placed in the femoral groove.
不可复性髌骨脱位是一种罕见的损伤,但确实发生的此类损伤主要是关节内方向的。在本病例中,一名53岁女性从椅子上跌落时发生了锁定性外侧髌骨脱位。术前CT扫描显示股内侧肌附着处、内侧支持带存在骨撕脱,髌韧带从髌骨尖部部分断裂。需要进行切开复位,并用锚钉系统和缝线重新连接撕裂的结构。术后管理包括强化物理治疗。术后1年,患者无肿胀或疼痛,步态正常,但屈曲受限至120度。所有术后X线片显示髌骨正确置于股骨沟内。