髌股关节不稳定是否为半伸直胫骨钉内固定的禁忌证？：1 例报告。
Is Patellar Instability a Contraindication to Semiextended Tibial Nailing?: A Case Report.
机构信息
Department of Orthopaedics, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Department of Orthopaedic Surgery, Tufts Medical Center, Boston, Massachusetts.
出版信息
JBJS Case Connect. 2023 Apr 18;13(2). doi: e20.00261. eCollection 2023 Apr 1.
CASE
We report a 40-year-old woman with undiagnosed patellofemoral instability that worsened 8 months after intramedullary nailing of a distal left tibia fracture in the semiextended position through a partial medial parapatellar approach. Patella stability and asymptomatic knee function were restored after IM nail removal, medial patellofemoral ligament repair, and left tibial tubercle transposition.
CONCLUSION
The optimal surgical approach for tibial IM nailing in patients with chronic patellar instability has not been described. Clinicians should be cognizant of the potential for worsening patellofemoral instability in these patients when using the medial parapatellar approach in the semiextended position.
病例
我们报告了一例 40 岁女性患者，其髌股关节不稳未经诊断，在半伸展位经内侧髌旁入路行左胫骨远端髓内钉固定术 8 个月后病情加重。在取出髓内钉、修复内侧髌股韧带和左胫骨结节内移后，髌骨稳定性和无症状的膝关节功能得以恢复。
结论
慢性髌骨不稳定患者胫骨髓内钉的最佳手术入路尚未描述。当在半伸展位使用内侧髌旁入路时，临床医生应该意识到这种情况下髌股关节不稳定加重的潜在风险。
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