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[急性髌骨脱位后髌骨关节面骨折]

[Osteochondral fracture of the patella after acute dislocation].

作者信息

Matoković Damir, Haspl Miroslav, Smilović Josko, Gotovac Nikola

机构信息

Opća zupanijska bolnica Pozega, Odjel ortopedije.

出版信息

Lijec Vjesn. 2011 May-Jun;133(5-6):187-9.

Abstract

Acute patellar dislocation is a common injury in young athletes, which occurs due to inappropriate biomechanical relations and anatomic deviations in the area of knee joint. In these unfavorable conditions, abrupt and vigorous strain of the quadriceps muscle of the thigh may result in lateral patellar dislocation. A case is presented of a young male athlete with acute patellar dislocation and consequential osteochondral fracture. Although x-ray showed normal knee finding, typical history, clinical examination and magnetic resonance image of the knee indicated arthroscopy, which confirmed the diagnosis ofpatellar dislocation. The osteochondral fragment was found and fastened by screws, thus reconstructing the articular surface of the patella. Medial patellar stabilizers were strengthened and lateral stabilizers loosened, thus re-establishing its anatomic slide way. On second-look operation, the screws were removed. In this case, good anatomic and functional outcome was achieved by timely operative treatment, joint surface reconstruction and rehabilitation.

摘要

急性髌骨脱位是年轻运动员的常见损伤,其发生是由于膝关节区域生物力学关系不当和解剖结构异常。在这些不利条件下,大腿股四头肌突然剧烈拉伸可能导致髌骨外侧脱位。本文介绍了一例年轻男性运动员急性髌骨脱位并继发骨软骨骨折的病例。尽管X线显示膝关节无异常,但典型的病史、临床检查及膝关节磁共振成像提示需进行关节镜检查,结果证实为髌骨脱位。发现骨软骨碎片并用螺钉固定,从而重建髌骨的关节面。加强髌骨内侧稳定器并松解外侧稳定器,从而重新建立其解剖滑动路径。在二次手术时取出螺钉。在该病例中,通过及时的手术治疗、关节面重建和康复,取得了良好的解剖和功能效果。

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