Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Division of Orthopaedics, Department of Surgery, McGill University, Montreal, Quebec, Canada.
JBJS Case Connect. 2022 Sep 1;12(3). doi: e22.00251. eCollection 2022 Jul 1.
A 32-year-old patient was diagnosed with a vertical patella fracture nonunion after a bone-patellar tendon-bone (BTB) anterior cruciate ligament reconstruction. In addition, a 1 × 2 × 1 cm patellar bone defect was noticed at the graft harvesting site. The patient was treated surgically with open reduction and internal fixation and iliac crest bone autograft which resulted in fracture union.
Many intraoperative and postoperative risk factors for iatrogenic patella fracture when harvesting BTB autograft were identified. Surgeons should be aware of technical skills needed to prevent this complication and should treat the fracture appropriately to avoid nonunion and optimize the outcome.
一名 32 岁患者在进行骨-髌腱-骨（BTB）前交叉韧带重建后，被诊断为垂直髌骨骨折不愈合。此外，在移植物采集部位还发现了 1×2×1cm 的髌骨骨缺损。患者接受了切开复位内固定和髂嵴骨自体移植的手术治疗，最终骨折愈合。
在采集 BTB 自体移植物时，许多术中及术后医源性髌骨骨折的风险因素已被确定。外科医生应了解预防这种并发症所需的技术技能，并应适当治疗骨折，以避免不愈合并优化结果。
