Lipscomb P R, Lipscomb P R, Bryan R S
J Bone Joint Surg Am. 1978 Mar;60(2):235-40.
We reviewed six patients with a five to fifteen-year follow-up and a seventh with shorter follow-up who underwent replacement and fixation with easily removable pins of large osteocartilaginous fragments resulting from osteochondritis dissecans. Excellent or good results were achieved in all but one patient. Preparation of the fragments to fit into their vascularized beds prior to internal fixation is advisable, and in some cases the bed should be partially filled with cancellous bone before the fragments are replaced. Immobilization is prescribed until the pins are removed three to six weeks after surgery. Weightbearing is delayed until there is roentgenographic evidence of beginning union of the fragment to the underlying bone.
我们回顾了6例接受了5至15年随访的患者，以及第7例随访时间较短的患者，这些患者均因剥脱性骨软骨炎而接受了大的骨软骨碎片的置换并用易于取出的钢针固定。除1例患者外，其余患者均取得了优异或良好的效果。建议在进行内固定之前将碎片修整以适配其血运丰富的床面，在某些情况下，在碎片复位之前应先用松质骨部分填充床面。术后需进行固定，直至术后三至六周取出钢针。在X线片显示碎片与下方骨骼开始愈合之前，应推迟负重。
