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超声引导下女性篮球运动员髌腱应力性骨折螺钉固定:1 例报告。

Ultrasound-guided screw fixation for patellar stress fracture in a female basketball player: A case report.

机构信息

Sports Medicine & Joint Center, Funabashi Orthopedic Hospital, Funabashi, Japan.

Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA.

出版信息

Medicine (Baltimore). 2022 Aug 19;101(33):e30040. doi: 10.1097/MD.0000000000030040.

Abstract

INTRODUCTION

Stress fracture of the patella is an overuse disorder that occurs in the lower extremity. Surgery may be considered if conservative treatment does not work or if a quicker and more reliable return to sports is expected. Surgery is usually performed under fluoroscopic guidance based on the premise that the proper placement of the internal fixation material can be determined on radiographic images.

PATIENT CONCERNS

A 16-year-old female basketball player gradually became aware of pain in the anterior aspect of her right knee during basketball, without any particular history of trauma. A computed tomography scan revealed a small bone fragment on the lateral side of the distal end of the patella.

DIAGNOSIS

Stress fracture of the patella.

INTERVENTIONS

Since it was difficult to determine the exact location of the bone fragment on radiographs, the surgery was performed under ultrasound guidance rather than fluoroscopy. While checking the bone fragment with ultrasound images, insertion of the guide pin, drilling, and screw fixation were performed under ultrasound guidance.

OUTCOMES

Postoperative computed tomography showed accurate screw insertion into the bone fragment. Two months after surgery, bony fusion was confirmed, and the patient returned to her preinjury level of basketball.

CONCLUSION

Ultrasound-guided screw fixation was useful in this case in which internal fixation of fractures is difficult under fluoroscopic guidance.

摘要

介绍

髌骨应力性骨折是一种下肢过度使用疾病。如果保守治疗无效,或者预计更快、更可靠地恢复运动,可能需要考虑手术。手术通常在透视引导下进行,前提是可以在影像学图像上确定内置固定材料的正确位置。

患者关注

一名 16 岁的女性篮球运动员在打篮球时逐渐感觉到右膝前侧疼痛,没有任何特定的外伤史。计算机断层扫描显示髌骨远端外侧有一小骨碎片。

诊断

髌骨应力性骨折。

干预措施

由于在 X 光片上很难确定骨碎片的确切位置,因此手术是在超声引导下而不是透视引导下进行的。在使用超声图像检查骨碎片的同时,在超声引导下进行导针插入、钻孔和螺钉固定。

结果

术后 CT 显示螺钉准确插入骨碎片。术后 2 个月,确认骨融合,患者恢复到受伤前的篮球水平。

结论

在透视引导下内固定困难的情况下,超声引导下螺钉固定在这种情况下很有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7406/9387984/98b5c99a2974/medi-101-e30040-g001.jpg

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