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两例髌腱自胫骨和髌骨联合撕脱的病例。

Two cases of combined patellar tendon avulsion from the tibia and patella.

作者信息

Bradko Viachaslau, Stoll William T, Haruno Lee S, Rosenfeld Scott B, McKay Scott D

机构信息

Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX, USA - Division of Orthopaedic Surgery, Texas Children's Hospital, Houston, TX, USA.

Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX, USA.

出版信息

SICOT J. 2018;4:17. doi: 10.1051/sicotj/2018014. Epub 2018 May 23.

DOI:10.1051/sicotj/2018014
PMID:29792785
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5967859/
Abstract

Avulsion fractures of the inferior pole of the patella and proximal tibial apophysis are independently rare injuries. They occur in children due to the relative weakness of the apophyseal cartilage compared to the ligaments and tendons. The combination of these two fractures, is exceedingly rare, with only a few previously described cases in the literature. Due to the infrequent presentation of this injury, careful examination and consideration of advanced imaging is important for diagnosis and preoperative planning. Here we present two cases of combined sleeve fractures of the inferior pole of the patella and tibial apophysis, with discussion of the pathophysiology, classification, identification and management of the injury.

摘要

髌骨下极撕脱骨折和胫骨近端骨骺撕脱骨折各自都是罕见的损伤。它们发生在儿童身上是因为与韧带和肌腱相比，骨骺软骨相对薄弱。这两种骨折同时出现极为罕见，文献中仅有少数先前描述的病例。由于这种损伤的表现不常见，仔细检查并考虑采用先进的影像学检查对于诊断和术前规划很重要。在此，我们报告两例髌骨下极和胫骨骨骺联合袖套状骨折的病例，并讨论该损伤的病理生理学、分类、识别及处理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/5abb15e50690/sicotj-4-17-fig9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/c6fd7abe0dd8/sicotj-4-17-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/0e4f8793f318/sicotj-4-17-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/f61c828a70c0/sicotj-4-17-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/185de4287932/sicotj-4-17-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/634b5d5085d7/sicotj-4-17-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/379418ac18ea/sicotj-4-17-fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/cd6f67978897/sicotj-4-17-fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/6325817b2255/sicotj-4-17-fig8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/5abb15e50690/sicotj-4-17-fig9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/c6fd7abe0dd8/sicotj-4-17-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/0e4f8793f318/sicotj-4-17-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/f61c828a70c0/sicotj-4-17-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/185de4287932/sicotj-4-17-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/634b5d5085d7/sicotj-4-17-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/379418ac18ea/sicotj-4-17-fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/cd6f67978897/sicotj-4-17-fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/6325817b2255/sicotj-4-17-fig8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f10/5967859/5abb15e50690/sicotj-4-17-fig9.jpg

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本文引用的文献

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Avulsion Fracture of the Tibial Tubercle Associated With Patellar Tendon Avulsion.胫骨结节撕脱骨折伴髌腱撕脱
Orthopedics. 2016 May 1;39(3):e561-4. doi: 10.3928/01477447-20160414-02. Epub 2016 Apr 18.
2
Combined Tibial Tubercle Avulsion Fracture and Patellar Avulsion Fracture: An Unusual Variant in an Adolescent Patient.胫骨结节撕脱骨折合并髌骨撕脱骨折：一名青少年患者的罕见变异情况
Am J Orthop (Belle Mead NJ). 2016 Jan;45(1):E31-4.
3
Bifocal osseous avulsion of the patellar tendon from the distal patella and tibial tuberosity in a child.
Cureus. 2021 Jun 1;13(6):e15368. doi: 10.7759/cureus.15368. eCollection 2021 Jun.
4
Bifocal Patellar Tendon Avulsion Fractures in Children and Adolescents: Diagnosis and Treatment Considerations for a Unique Injury Pattern.儿童和青少年双焦点髌腱撕脱骨折：一种独特损伤模式的诊断与治疗考量
Arthrosc Sports Med Rehabil. 2020 Dec 27;3(1):e97-e103. doi: 10.1016/j.asmr.2020.08.013. eCollection 2021 Feb.
儿童髌腱自髌骨远端和胫骨结节的双焦点骨性撕脱
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J Pediatr Orthop. 2004 Mar-Apr;24(2):181-4. doi: 10.1097/00004694-200403000-00009.
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Avulsion fracture of the tibial tubercle with avulsion of the patellar ligament. Report of two cases.胫骨结节撕脱骨折伴髌韧带撕脱。两例报告。
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