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[髌骨骨折]

[Patella fractures].

作者信息

Galla M, Lobenhoffer P

机构信息

Klinik für Unfall- und Wiederherstellungschirurgie, Henriettenstiftung Hannover.

出版信息

Chirurg. 2005 Oct;76(10):987-97; quiz 998-9. doi: 10.1007/s00104-005-1081-3.

Abstract

Patella fractures are relatively uncommon, accounting for approximately 0.5% to 1.5% of all skeletal injuries. The most common mechanism for this injury is direct fall onto the knee, and transverse fracture is the most common type. The aims of operative treatment are accurate reduction and rigid fixation. Stable fracture types without or with minimal dislocation can be treated nonoperatively. Dislocation of more than 2 mm and comminuted fractures are indications for operative treatment. Tension band wiring, interfragmentary screw fixation, and the combination of cerclage wiring and screw fixation are used for internal fixation of these fractures. When accurate reduction and reconstruction of the retropatellar joint surface cannot be achieved in multi-fragmentary fractures, partial or total patellectomy should be considered. Since it always results in loss of quadriceps muscle power, the decision for this procedure should be made cautiously.

摘要

髌骨骨折相对少见,约占所有骨骼损伤的0.5%至1.5%。这种损伤最常见的机制是直接跪倒在地,横行骨折是最常见的类型。手术治疗的目的是精确复位和坚强固定。无移位或移位极小的稳定骨折类型可采用非手术治疗。移位超过2毫米的骨折和粉碎性骨折是手术治疗的指征。张力带钢丝固定、骨折块间螺钉固定以及钢丝环扎与螺钉固定联合应用可用于这些骨折的内固定。对于多块骨折若无法实现髌骨后关节面的精确复位和重建,则应考虑部分或全部髌骨切除术。由于该手术总会导致股四头肌肌力丧失,因此应谨慎做出该手术的决定。

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