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关节内髌骨水平脱位:一种罕见的损伤并文献复习。

Intra-articular horizontal dislocation of the patella: a rare injury and review of the literature.

机构信息

Department of Orthopaedic Surgery and Traumatology, Inselspital University of Bern, Bern, Switzerland

Department of Orthopaedic Surgery and Traumatology, Inselspital University of Bern, Bern, Switzerland.

出版信息

BMJ Case Rep. 2020 Jul 9;13(7):e232249. doi: 10.1136/bcr-2019-232249.

Abstract

Acute traumatic intra-articular dislocation of the patella is not a common presentation in orthopaedic practice; less frequently observed than extra-articular dislocation of the patella. In some of these cases, closed reduction is not possible and an open reduction in the operating theatre must be performed. In this case report, we present an elderly patient with an intra-articular horizontal dislocation of the patella without any other bony or ligamentous lesions seen in a postreduction MRI. We conducted a literature review looking at intra-articular patella dislocations, identifying 64 published studies (articles, case reports and papers). The following sources of data were searched until December 2017: PubMed, OVID, Google Scholar, Scopus, using the search strategy of (intra-articular dislocation of patella, horizontal patellar dislocation) with no limitation on the year or language of publication. The patient presented in this case report was managed with a closed reduction under general anaesthesia, without the need of any surgical intervention. As proposed in the literature, the hypothesis of an intra-articular entrapment of the patella due to the trapped osteophytes of the superior pole of the patella into the intercondylar notch was thought to be the cause of intra-articular dislocation in this elderly patient.

摘要

急性创伤性髌骨关节内脱位在骨科实践中并不常见;比髌骨关节外脱位少见。在这些病例中,闭合复位是不可能的,必须在手术室进行切开复位。在本病例报告中,我们介绍了一位老年患者,其髌骨关节内水平脱位,无其他骨或韧带损伤,在复位后 MRI 上可见。我们进行了文献回顾,研究了髌骨关节内脱位,确定了 64 篇已发表的研究(文章、病例报告和论文)。直到 2017 年 12 月,我们在以下数据源中搜索了数据:PubMed、OVID、Google Scholar、Scopus,使用的搜索策略为(髌骨关节内脱位、髌骨关节内水平脱位),对发表年份和语言没有限制。本病例报告中的患者在全身麻醉下接受了闭合复位,无需任何手术干预。正如文献中提出的,由于髌上极的骨赘嵌入髁间窝,导致髌骨关节内嵌顿,这被认为是这位老年患者发生髌骨关节内脱位的原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/935e/7351279/71d6e101e374/bcr-2019-232249f01.jpg

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