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跖骨钩钢板在治疗多片段髌骨骨折中的应用——病例系列

Use of metatarsal hook plates in the treatment of multifragmentary patellar fractures - A case series.

作者信息

Barros Edgar Alejandro, Ballesteros Carlos, Noboa Carlos Eduardo, Arteaga Gonzalo, Peñaherrera Carlos, Endara Francisco, Bravo Andrés, Barros Castro Alejandro Xavier

机构信息

Orthopedics and Traumatology Service, Hospital Vozandes Quito and Hospital Metropolitano, Quito - Ecuador.

Postgraduate Course in Orthopedics and Traumatology at the International University of Ecuador, Quito - Ecuador.

出版信息

Trauma Case Rep. 2024 Apr 8;51:101018. doi: 10.1016/j.tcr.2024.101018. eCollection 2024 Jun.

Abstract

UNLABELLED

The surgical management of patellar fractures typically yielded satisfactory results; however, in situations involving multifragmented patellar fractures or those affecting the inferior pole, it became imperative to employ alternative osteosynthesis techniques that enhanced stability, enabled early rehabilitation initiation, prevented implant failure, and avoided reduction loss before fracture consolidation. In this context, an unconventional osteosynthesis alternative was presented, utilizing an anatomically designed hook plate originally intended for the fifth metatarsal. This technique was successfully applied in three patients with multifragmentary patellar fractures, allowing stable fixation of small or marginal fragments through the plate's hooks without compromising vascularity. Fracture consolidation was achieved without reduction loss, and owing to its low profile, patient discomfort and irritation were minimized compared to traditional tension band or wiring techniques. This approach suggested the potential to forego early plate removal, thereby contributing to a more effective management of patellar fractures.

LEVEL OF EVIDENCE

IV.

摘要

未标注

髌骨骨折的手术治疗通常能取得满意的效果;然而,在涉及多碎片髌骨骨折或影响下极的骨折情况中,采用能增强稳定性、允许早期开始康复治疗、防止植入物失败并避免骨折愈合前复位丢失的替代骨合成技术变得至关重要。在此背景下,提出了一种非传统的骨合成替代方法,使用最初设计用于第五跖骨的解剖学设计钩板。该技术成功应用于3例多碎片髌骨骨折患者,通过板的钩实现小或边缘碎片的稳定固定,而不影响血运。骨折实现愈合且无复位丢失,并且由于其外形低,与传统张力带或钢丝技术相比,患者不适和刺激最小化。这种方法表明有可能无需早期取出钢板,从而有助于更有效地治疗髌骨骨折。

证据级别

IV。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39f3/11019277/1979bf48b95d/gr1.jpg

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