Krödel A, Refior H J
Orthopädische Klinik, Ludwig-Maximilians-Universität München, Klinikum Grosshadern.
Unfallchirurgie. 1990 Feb;16(1):12-7. doi: 10.1007/BF02587990.
Acute traumatic dislocation of the patella may be associated with osteochondral fractures. Clinical examination invariably shows a tense effusion. A detailed radiographic examination including antero-posterior, lateral and skyline views of the patella is usually necessary to establish an exact diagnosis. Once diagnosis is made open reduction and fixation of the osteochondral fracture should be carried out if it is possible. Out of 78 patients of our own with patella dislocation 24 cases suffered an osteochondral fracture. In ten cases refixation of the osteochondral fragment was achieved. Intraoperatively the alignment of the patella was controlled in any case. In cases of lateral subluxation lateral release and medial reconstruction was performed. In two cases medial transfer of the tibial tuberosity was carried out. Osteochondral fractures of the femoro-patellar groove represent an important injury in the course of acute patellar dislocation. With exact diagnosis and correct treatment congruity of the femoro-patellar joint can be restored in many cases.
急性创伤性髌骨脱位可能与骨软骨骨折相关。临床检查总是显示有紧张的积液。通常需要进行详细的影像学检查，包括髌骨的前后位、侧位和髌股关节切线位片，以明确诊断。一旦确诊，如果可能，应进行骨软骨骨折的切开复位和内固定。在我们自己的78例髌骨脱位患者中，有24例发生了骨软骨骨折。其中10例实现了骨软骨碎片的重新固定。术中无论如何都要检查髌骨的对线情况。对于外侧半脱位的病例，进行外侧松解和内侧重建。有2例进行了胫骨结节内移。髌股关节面的骨软骨骨折是急性髌骨脱位过程中的一种重要损伤。通过准确的诊断和正确的治疗，许多情况下髌股关节的一致性可以恢复。
