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青少年远端髌腱撕脱的延迟诊断和治疗。

Delayed diagnosis and treatment of a distal patellar tendon avulsion in an adolescent.

机构信息

Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.

PCOM, Philadelphia, Pennsylvania, USA.

出版信息

BMJ Case Rep. 2022 Feb 28;15(2):e248526. doi: 10.1136/bcr-2021-248526.

DOI:10.1136/bcr-2021-248526
PMID:35228250
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8886437/
Abstract

Distal patellar tendon avulsions are uncommon. While much is known about proximal patella tendon ruptures, there are very few reports to guide treatment of a patellar tendon disruption near the tibial tuberosity. Moreover, delayed diagnosis and treatment presents additional challenges. We present a distal patellar tendon avulsion in an adolescent whereby diagnosis and treatment were delayed due to a distracting nearby contaminated wound. The tendon was separated from post-traumatic scar then repaired back to its native footprint using suture anchors. This report aims to increase awareness of this rare diagnosis as well as provide details about our chosen treatment and rehabilitation protocol.

摘要

髌腱远侧止点撕脱较为少见。虽然人们对髌腱近侧止点断裂已有较多了解,但对于胫骨结节附近髌腱断裂的治疗,相关报道却很少。此外,延迟诊断和治疗会带来更多挑战。我们报告了一例青少年髌腱远侧止点撕脱,由于附近有一处分散注意力的污染伤口,导致诊断和治疗延迟。我们通过缝线锚钉将肌腱从创伤后瘢痕中分离出来,然后修复至其原始止点。本报告旨在提高对这一罕见诊断的认识,并详细介绍我们选择的治疗和康复方案。

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1
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本文引用的文献

1
Traumatic Rupture of the Patellar Tendon From the Tibial Tuberosity in an Adult: A Case Report.成人髌腱自胫骨结节处的创伤性断裂:一例报告
Cureus. 2021 Oct 26;13(10):e19050. doi: 10.7759/cureus.19050. eCollection 2021 Oct.
2
Repair of Patellar Tendon Avulsion from the Tibial Tubercle: Case Report.胫骨结节髌腱撕脱伤的修复:病例报告
J Orthop Case Rep. 2019;9(5):26-30. doi: 10.13107/jocr.2250-0685.1518.
3
Knee sliced open by skate blade: complete patellar tendon rupture in an elite long track speed skater.膝盖被冰刀割开:一名优秀的长道速滑运动员髌腱完全断裂。
BMJ Case Rep. 2019 Apr 14;12(4):e228611. doi: 10.1136/bcr-2018-228611.
4
Acute traumatic rupture of the patellar tendon in pediatric population: Case series and review of the literature.儿童人群髌腱急性创伤性断裂:病例系列及文献综述
Injury. 2017 Nov;48(11):2515-2521. doi: 10.1016/j.injury.2017.08.069. Epub 2017 Sep 1.
5
Acute Traumatic Patellar Tendon Rupture at the Tibial Tuberosity Attachment without Avulsion Fracture.胫骨结节附着处急性创伤性髌腱断裂,无撕脱骨折。
Case Rep Orthop. 2017;2017:2537028. doi: 10.1155/2017/2537028. Epub 2017 Aug 10.
6
Distal patellar tendon avulsion in association with high-energy knee trauma: A case series and review of the literature.髌腱远端撕脱合并高能膝关节创伤:病例系列报道及文献综述
Knee. 2017 Mar;24(2):468-476. doi: 10.1016/j.knee.2016.10.020. Epub 2016 Dec 1.
7
Long-term functional outcomes after primary surgical repair of acute and chronic patellar tendon rupture: Series of 25 patients.急性和慢性髌腱断裂一期手术修复后的长期功能结果:25例患者系列研究
Ann Phys Rehabil Med. 2017 Jul;60(4):244-248. doi: 10.1016/j.rehab.2016.10.003. Epub 2016 Nov 25.
8
Transosseous-Equivalent Repair for Distal Patellar Tendon Avulsion.经骨等效修复治疗髌腱远端撕脱
Arthrosc Tech. 2016 Apr 18;5(2):e385-9. doi: 10.1016/j.eats.2016.01.020. eCollection 2016 Apr.
9
Return to Sports and Subsequent Injury Rates After Revision Anterior Cruciate Ligament Reconstruction With Patellar Tendon Autograft.髌腱自体移植翻修前交叉韧带重建术后恢复运动及后续损伤率
Am J Sports Med. 2014 Jun;42(6):1395-400. doi: 10.1177/0363546514524921. Epub 2014 Mar 13.
10
Suture anchor repair yields better biomechanical properties than transosseous sutures in ruptured quadriceps tendons.在股四头肌肌腱断裂修复中,缝线锚钉修复比经骨缝线具有更好的生物力学性能。
Knee Surg Sports Traumatol Arthrosc. 2015 Apr;23(4):1039-45. doi: 10.1007/s00167-014-2854-3. Epub 2014 Jan 29.