van Raay J J, van Loon A, Wissing J C, van der Werken C
St. Elisabeth Ziekenhuis, afd. Heelkunde, Tilburg.
Ned Tijdschr Geneeskd. 1990 Jul 7;134(27):1308-11.
When accurate reduction and stable fixation cannot be achieved in comminuted patellar fractures, degenerative changes in the patellofemoral joint can cause troublesome complaints. Our results show that partial or total patellectomy can produce a very good percentage of satisfactory results. In spite of several biomechanical studies that demonstrated the reduced efficiency of the quadriceps mechanism after partial and total excision of the patella, most patients achieved good or excellent results after a long follow-up period. All patients showed decreased isokinetic performance of the quadriceps muscle. There was no clear correlation between the clinical score and the data on isokinetic performance. Patellofemoral or femorotibial osteoarthritis and calcifications in the patellar ligament did not lead to an unsatisfactory clinical result.
当粉碎性髌骨骨折无法实现精确复位和稳定固定时，髌股关节的退行性改变可能会引发令人困扰的症状。我们的结果表明，部分或全部髌骨切除术可产生相当高比例的满意结果。尽管多项生物力学研究表明，部分或全部切除髌骨后股四头肌机制的效率会降低，但大多数患者在长期随访后仍取得了良好或优异的结果。所有患者的股四头肌等速运动表现均下降。临床评分与等速运动表现数据之间没有明显的相关性。髌股或股胫骨关节炎以及髌韧带钙化并未导致不满意的临床结果。
