Stepanovich Matthew T, Slakey Joseph B
Bone and Joint Sports Medicine Institute, Naval Medical Center Portsmouth, Portsmouth, VA.
Am J Orthop (Belle Mead NJ). 2016 Jan;45(1):E31-4.
Traumatic extensor dysfunction of the knee in children is a rare injury, with the majority resulting from tibial tubercle avulsion fracture or patellar sleeve fracture. We report a rare case of combined patellar avulsion fracture and tibial tubercle fracture. With open anatomic reduction, both injuries were successfully treated. While many variations of tibial tubercle fracture have been reported, the authors believe this to be the first report in the English-language literature of this particular combined injury to the knee extensor mechanism in an adolescent. Advanced imaging with computed tomography provided vital information to aid with operative planning, especially since the majority of the unossified tubercle was not seen on plain radiographs, and all fracture fragments were originally believed to be from the tibial tubercle. Computed tomography distinguished the patellar fracture from the tibial tubercle fragments, verifying preoperatively the complexity of the injury.
儿童膝关节创伤性伸肌功能障碍是一种罕见的损伤，多数由胫骨结节撕脱骨折或髌袖骨折引起。我们报告一例罕见的髌骨撕脱骨折合并胫骨结节骨折病例。通过切开解剖复位，两处损伤均得到成功治疗。虽然已有许多关于胫骨结节骨折的变异报道，但作者认为这是英文文献中首例关于青少年膝关节伸肌机制这种特殊复合损伤的报道。计算机断层扫描（CT）高级成像提供了重要信息，有助于手术规划，特别是因为在平片上未发现大部分未骨化的结节，且最初所有骨折碎片都被认为来自胫骨结节。CT区分了髌骨骨折和胫骨结节碎片，术前证实了损伤的复杂性。
