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髌骨骨折伴膝关节伸肌机制修复的骨合成:病例报告。

Osteosynthesis of a patellar fracture with repair of the knee extensor mechanism: Case report.

作者信息

Araujo José Torrealba, Hernández Mauricio Núñez, Romero David Quilodrán, Encina Lizandra Rojas

机构信息

Finis Terrae University, Chile.

Instituto de Seguridad del Trabajador, Santiago, Chile.

出版信息

Trauma Case Rep. 2023 May 22;46:100851. doi: 10.1016/j.tcr.2023.100851. eCollection 2023 Aug.

Abstract

Patella fractures correspond to 1 % of all fractures. In recent decades, the role of the patella in increasing the lever arm of the quadriceps has been well defined. Surgical treatment is indicated for open fractures, those that compromise the function of the extensor mechanism, those with a joint gap >5 mm and/or joint incongruity >3 mm, a group that corresponds to around 30 % of the total. Anatomical reduction and stabilization with various types of modified tension bands is the most frequently used procedure. Biomechanical studies have shown that stabilization through the use of a tension band replacing the Kirchner wires with cannulated screws presents adequate resistance to fracture displacement and provides greater stability than the classic configuration, maintaining the theoretical principle of converting the forces of anterior tension of the patella generated by the quadriceps in compression at the level of the articular surface. A case of a patient who required reduction and osteosynthesis of an exposed patella fracture, associated with an extensor mechanism lesion, is presented. Clinical and radiographic characteristics of the patient and the resolution of the case are described.

摘要

髌骨骨折占所有骨折的1%。近几十年来,髌骨在增加股四头肌力臂方面的作用已得到明确界定。对于开放性骨折、那些影响伸膝机制功能的骨折、关节间隙>5mm和/或关节不平整>3mm的骨折,建议进行手术治疗,这类骨折约占总数的30%。采用各种改良张力带进行解剖复位和固定是最常用的方法。生物力学研究表明,用空心螺钉替代克氏针的张力带固定对骨折移位具有足够的抵抗力,并且比经典构型提供更大的稳定性,保持了将股四头肌产生的髌骨前张力转化为关节面水平压缩力的理论原则。本文介绍了一例需要对暴露的髌骨骨折进行复位和骨固定的患者病例,该骨折伴有伸膝机制损伤。描述了患者的临床和影像学特征以及病例的解决情况。

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