Lippacher S, Reichel H, Nelitz M
Orthopädische Universitätsklinik Ulm am RKU, Oberer Eselsberg 45, 89081, Ulm, Deutschland.
Orthopade. 2010 May;39(5):516-8. doi: 10.1007/s00132-010-1609-1.
We report on a 20-year-old female patient with a fracture of the patella after she fell on"black ice" 2 months after medial patellofemoral ligament (MPFL) reconstruction for patellar instability. For reconstruction of the MPFL, a single hamstring tendon graft was passed through the medial intermuscular septum and was fixed to the superomedial pole of the patella. The fracture was reduced by wire cerclage. Intraoperatively it was shown that the fracture line went through the patellar drill hole. No complications occurred during the further postoperative period. The literature contains only a few case reports describing fractures of the patella after MPFL reconstruction without any specific trauma. In this case, an interruption in blood supply with resulting avascular necrosis was suspected as a causal factor.
我们报告了一名20岁女性患者,她在髌股内侧韧带(MPFL)重建治疗髌骨不稳2个月后,因踩在“黑冰”上而导致髌骨骨折。对于MPFL重建,采用单根腘绳肌腱移植物穿过内侧肌间隔并固定于髌骨的上内侧极。骨折通过钢丝环扎复位。术中发现骨折线穿过髌骨钻孔。术后进一步观察期间未发生并发症。文献中仅有少数病例报告描述了MPFL重建后无任何特定创伤情况下的髌骨骨折。在本病例中,怀疑血供中断导致的缺血性坏死是一个致病因素。