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[使用麦克劳克林环扎术治疗髌骨骨折和髌腱断裂]

[Augmentation of patella fractures and patella tendon ruptures with the McLaughlin-Cerclage].

作者信息

Ahrberg A, Josten C

机构信息

Klinik für Unfall-, Wiederherstellungs- und Plastische Chirurgie, Universitätsklinikum Leipzig AöR, Liebigstrasse 20, 04103, Leipzig, Germany.

出版信息

Unfallchirurg. 2007 Aug;110(8):685-90. doi: 10.1007/s00113-007-1269-8.

Abstract

Augmentation of patella injuries was first described in 1946 by H.F. McLaughlin. We retrospectively analyzed 14 patients with patella fracture or patella tendon rupture who had been augmented with McLaughlin wiring between 1998 and 2004. The Insall-Salvati ratio was determined before and after removing the cerclage wire as well as on the opposite knee to assess the patella position; in addition the degree of retropatellar arthritis was determined. The functional results were ascertained by Larson and OAK score. McLaughlin wiring influenced the patella position in two patients. Most of the patients achieved a good or very good functional result (mean Larson score 82.39, mean OAK score 82.79). In six patients (42.86%) the degree of retropatellar arthritis was higher than in the opposite knee. Three patients (21.43%) needed secondary arthrolysis at the time of removal of the cerclage. Arthritis and functional results were worse in patients with complex knee trauma. Therefore augmentation with the McLaughlin cerclage in combination with standardized postoperative after treatment is a sufficient therapy of patella fractures and patella tendon ruptures.

摘要

髌骨损伤的增强术最早于1946年由H.F.麦克劳克林描述。我们回顾性分析了1998年至2004年间14例接受麦克劳克林钢丝增强术治疗的髌骨骨折或髌腱断裂患者。在拆除环扎钢丝前后以及对侧膝关节测量Insall-Salvati比值以评估髌骨位置;此外,还确定了髌后关节炎的程度。通过拉尔森评分和OAK评分确定功能结果。麦克劳克林钢丝增强术对两名患者的髌骨位置产生了影响。大多数患者获得了良好或非常好的功能结果(平均拉尔森评分为82.39,平均OAK评分为82.79)。6例患者(42.86%)髌后关节炎程度高于对侧膝关节。3例患者(21.43%)在拆除环扎钢丝时需要进行二次关节松解术。复杂膝关节创伤患者的关节炎和功能结果较差。因此,麦克劳克林环扎术结合标准化术后治疗是治疗髌骨骨折和髌腱断裂的有效方法。

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