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一名14岁男孩在膝关节扭伤一年后,采用生物可吸收钉对漏诊的股骨滑车骨软骨碎片进行晚期修复。

Late Repair, One Year After a Knee Twisting Injury, of a Missed Femoral Trochlea Osteochondral Fragment, With Bioabsorbable Nails, in a 14-Year-Old Boy.

作者信息

Megremis Panos, Megremis Orestis, Margariti Rodanthi

机构信息

A' Orthopaedic Department, Athens Children's Hospital "P. & A. Kyriakou", Athens, Greece.

出版信息

J Am Acad Orthop Surg Glob Res Rev. 2019 Aug 5;3(8):e040. doi: 10.5435/JAAOSGlobal-D-18-00040. eCollection 2019 Aug.

Abstract

The authors report a case of a late repair of a missed, large, osteochondral fracture of the femoral trochlea in a 14-year-old boy due to lateral patellar dislocation after a twisting injury of the knee a year ago. The late-1 year after the knee injury-imaging assessment of the patient regarding radiograph images, CT scan, and MRI was misleading, misinterpreted, and failed to reveal this osteochondral fracture. The free osteochondral fragment was detected during diagnostic arthroscopy. Open reduction and fixation of the osteochondral fragment with bioabsorbable pins were done, and healing was achieved within an acceptable time. The patient's clinical and imaging examination with knee MRI, a year after the surgical treatment, was highly satisfactory. Fixation with bioabsorbable pins showed to be a worthwhile option in this case. The technique used was straightforward, with excellent short- and long-term results. Bioabsorbable pins may be used to restore successfully even an old, large osteochondral fracture in the immature skeleton.

摘要

作者报告了一例14岁男孩的病例,该男孩在一年前膝关节扭伤后因髌骨外侧脱位导致股骨滑车一处漏诊的大型骨软骨骨折延迟修复。膝关节损伤1年后对患者进行的影像学评估,包括X线片、CT扫描和MRI,结果具有误导性,解读错误,未能发现该骨软骨骨折。在诊断性关节镜检查期间发现了游离的骨软骨碎片。采用生物可吸收针进行了骨软骨碎片的切开复位内固定,骨折在可接受的时间内愈合。手术治疗一年后,对患者进行的膝关节MRI临床和影像学检查结果非常令人满意。在这种情况下,使用生物可吸收针固定是一种值得选择的方法。所采用的技术简单直接,短期和长期效果都很好。生物可吸收针甚至可以成功修复未成熟骨骼中的陈旧性大型骨软骨骨折。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/804a/6754220/cdb42d583b79/jg9-3-e040-g001.jpg

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