El-Sayed Ahmed Mounir M, Ragab Raafat Kamal I
Assistant Professor of Orthopaedic Surgery and Traumatology, Department of Orthopaedic Surgery and Traumatology Faculty of Medicine, Menoufiya University, Egypt.
Knee. 2009 Jan;16(1):54-7. doi: 10.1016/j.knee.2008.07.010. Epub 2008 Sep 13.
Most patellar fractures are transverse involving the central third. Open reduction and stabilization of transverse patellar fractures is indicated if there is more than 2-3 mm of fragment separation and/or articular incongruity. Arthroscopic-assisted reduction and stabilization of displaced fractures of the patella had been reported as an alternative to open technique. The aim of this study was to report the results of arthroscopic-assisted reduction and fixation of displaced transverse fractures of the patella. Fourteen patients with 14 displaced transverse fractures of the patella were included in this prospective study. Patients were treated by arthroscopic-assisted closed reduction of the fracture with percutaneous screw fixation. Patients were followed up for a mean period of 26 months. All patients were males with an average age of 34 years. All fractures united in a mean period of 7 weeks. Twelve patients regained full knee range of motion and two patients had 10 degrees loss of full flexion. All patients regained full knee extension. Thigh muscle wasting was observed in nine patients with a mean value of 0.8 cm. The mean final Lysholm score was 93. Arthroscopic-assisted reduction and percutaneous screw fixation is an appropriate technique for displaced transverse patellar fractures without major separation or comminution. It offers good functional outcome with minimal complications.
大多数髌骨骨折为累及中1/3的横行骨折。如果骨折块分离超过2 - 3毫米和/或关节面不平整,则需行切开复位并固定横行髌骨骨折。关节镜辅助下复位及固定移位的髌骨骨折已被报道可作为切开手术的替代方法。本研究的目的是报告关节镜辅助下复位及固定移位横行髌骨骨折的结果。本前瞻性研究纳入了14例患有14处移位横行髌骨骨折的患者。患者接受关节镜辅助下骨折闭合复位及经皮螺钉固定治疗。患者平均随访26个月。所有患者均为男性,平均年龄34岁。所有骨折平均在7周内愈合。12例患者恢复了膝关节的全范围活动,2例患者完全屈曲丧失10度。所有患者均恢复了膝关节的完全伸直。9例患者出现股四头肌萎缩,平均值为0.8厘米。最终Lysholm评分的平均值为93分。关节镜辅助下复位及经皮螺钉固定是治疗无严重分离或粉碎的移位横行髌骨骨折的一种合适技术。它能提供良好的功能结果,并发症最少。