Yousef Mohamed A
Department of Orthopaedic Surgery, Texas Children's Hospital, Houston, TX, USA; Center for Advanced Orthopaedic Studies, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Knee. 2019 Dec;26(6):1250-1261. doi: 10.1016/j.knee.2019.10.012. Epub 2019 Nov 5.
The literature is limited on the etiology and outcome of acute traumatic knee extensor mechanism injuries in skeletally immature patients with lack of a reliable classification system.
Data on patients who sustained an acute traumatic injury of the knee extensor mechanism were reviewed with a minimum of 12-month follow-up. Functional outcome was evaluated regarding knee active range of motion. Functional outcome was described using the Knee Society Score (KSS). Data were expressed as mean ± standard deviation.
Seventy-two patients with 74 knee extensor mechanism injuries were identified. The age at the time of injury was 13.9 ± 1.9 years. They included 59 injuries with tibial tubercle avulsion fracture, six injuries with patellar tendon avulsion without bone injury, six injuries with combined patellar tendon avulsion with tibial tubercle fracture, two injuries with sleeve fracture, and one injury with quadriceps tendon avulsion. According to our classification, type IB1 injury was the commonest injury (79.7%). The time to return to sports was 5.23 ± 2.98 months. The flexion was 128.7° ± 13.3°. A mean terminal extension lag of 5.6° was detected in three patients (4.1%). The KSS was 94.8 ± 8.1 and the functional outcome was graded excellent in 64 patients (88.9%), good in seven patients (9.7%), and fair in one patient (1.4%).
Traumatic injuries of the knee extensor mechanism in skeletally immature patients represent a wide variety of injuries including bony injuries in 82.4% of cases reviewed, tendinous injuries in 9.5%, and both bone and tendinous injuries in 8.1%. Our proposed classification system provides a more precise description of the injury pattern.
关于骨骼未成熟患者急性创伤性膝关节伸肌机制损伤的病因和预后的文献有限，且缺乏可靠的分类系统。
回顾了膝关节伸肌机制急性创伤性损伤患者的数据，随访时间至少为12个月。评估膝关节主动活动范围的功能预后。使用膝关节协会评分（KSS）描述功能预后。数据以平均值±标准差表示。
共确定72例患者有74处膝关节伸肌机制损伤。受伤时的年龄为13.9±1.9岁。其中包括59例胫骨结节撕脱骨折、6例髌腱无骨损伤的撕脱、6例髌腱合并胫骨结节骨折的撕脱、2例袖状骨折和1例股四头肌肌腱撕脱。根据我们的分类，IB1型损伤是最常见的损伤（79.7%）。恢复运动的时间为5.23±2.98个月。屈曲角度为128.7°±13.3°。3例患者（4.1%）检测到平均终末伸展滞后5.6°。KSS评分为94.8±8.1，64例患者（88.9%）的功能预后评为优秀，7例患者（9.7%）为良好，1例患者（1.4%）为中等。
骨骼未成熟患者膝关节伸肌机制的创伤性损伤表现为多种损伤，在所回顾的病例中，82.4%为骨损伤，9.5%为肌腱损伤，8.1%为骨和肌腱联合损伤。我们提出的分类系统对损伤模式提供了更精确的描述。
