Halvorson Ryan T, Dilallo Marcus, Garcia-Lopez Edgar, Colyvas Nicholas, Wong Stephanie E
Department of Orthopaedic Surgery, University of California, San Francisco, California.
Arthrosc Tech. 2023 Nov 20;12(12):e2295-e2302. doi: 10.1016/j.eats.2023.07.058. eCollection 2023 Dec.
The management of chronic extensor mechanism injuries represents a significant challenge for orthopaedic surgeons, with numerous options for graft choice and fixation construct, but no clear consensus on which technique achieves optimal outcomes. Although there is little published data regarding outcomes of different fixation methods, small case series have demonstrated modest success using Achilles tendon bone block allografts and transverse patellar screw fixation. In this technical note, we describe a surgical technique for the treatment of a chronic inferior pole patella fracture, with extensor mechanism reconstruction using an Achilles tendon allograft with suture tape augmentation. Our technique describes the use of vertical cannulated screws in the patella for passing tape augmentation sutures, increased construct security by suturing of the Achilles graft directly to the quadriceps tendon, and the use of a post screw in the proximal tibia for suture tape augmentation.
慢性伸肌机制损伤的处理对骨科医生来说是一项重大挑战，在移植物选择和固定结构方面有众多选择，但对于哪种技术能取得最佳效果尚无明确共识。尽管关于不同固定方法的结果发表的数据很少，但小病例系列显示使用跟腱骨块同种异体移植物和横向髌骨螺钉固定取得了一定成功。在本技术说明中，我们描述了一种治疗慢性髌骨下极骨折的手术技术，采用带缝线带增强的跟腱同种异体移植物进行伸肌机制重建。我们的技术描述了在髌骨中使用垂直空心螺钉来穿过缝线带增强缝线，通过将跟腱移植物直接缝合到股四头肌肌腱来增加结构稳定性，以及在胫骨近端使用后置螺钉进行缝线带增强。
