Damaraju Sandeep, Eldesoki Ahmed, Shahban Shafiq A
Trauma and Orthopaedics, Walsall Healthcare NHS Trust, Walsall, GBR.
Cureus. 2024 Aug 28;16(8):e67994. doi: 10.7759/cureus.67994. eCollection 2024 Aug.
Ipsilateral patella and tibial plateau fractures represent an extremely rare injury pattern. They are seldom discussed in literature, with no frameworks for management being reported that we were able to find. We report our experience and management of such an injury, suffered by a 57-year-old female patient with good premorbid functional status, by direct trauma to the right knee. Preoperatively, she was managed in a knee splint to aid elevation and help control her pain. We undertook fixation of both the patella and tibia through a midline incision. Postoperatively, we used a hinged knee brace, initially locked in extension, to allow gradual flexion at two weekly follow-ups. She has suffered no postoperative complications thus far at three months. We hope to highlight a novel management plan for this rare and complex fracture pattern, for which no prior published management evidence exists. As such, we submit the key principles from which our operative plan was derived to aid in the management of such injuries in the future.
同侧髌骨和胫骨平台骨折是一种极为罕见的损伤模式。文献中很少对其进行讨论，我们也未能找到已报道的相关治疗框架。我们报告了一名57岁、病前功能状态良好的女性患者因右膝直接外伤而遭受此类损伤的治疗经验。术前，她使用膝关节夹板来辅助抬高并帮助控制疼痛。我们通过中线切口对髌骨和胫骨进行固定。术后，我们使用了铰链式膝关节支具，最初锁定在伸直位，在每两周的随访中逐渐增加屈曲角度。到三个月时，她目前尚无术后并发症。我们希望强调针对这种罕见且复杂骨折模式的一种新的治疗方案，此前尚无已发表的治疗证据。因此，我们提出了制定手术方案所依据的关键原则，以帮助未来处理此类损伤。
