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[髌骨病灶,骨结核一种罕见的定位形式]

[The patellar focus, a rare form of localization of bone tuberculosis].

作者信息

Richter R, Herceg K, Köhler G

出版信息

Z Orthop Ihre Grenzgeb. 1982 Feb;120(1):5-9. doi: 10.1055/s-2008-1051565.

Abstract

Patellar foci of any origin are very rare. Form 1955 to the end of 1979, 9 patients underwent patellar surgery in our hospital. 7 of these patients had tuberculosis, whereas in one case the patient had chronic nonspecific osteomyelitis, and in one case we were unable to clarify the underlying cause of the focus, neither from the histological nor from the bacteriological aspect. All tuberculous foci, one of which had penetrated into the knee joint, were situated in the corpus of the patellar. In a 10-year old girl, the entire patellar was infected with tuberculous foci. In the anterior-posterior x-ray film, the processes mainly presented a circular appearance. Their diameter different between 6 and 25 mm. In one of the foci, two sequesters were conspicuous, and one in another patient. 6 of the patients had an active organ tuberculosis at the same time, or reported on a specific disease during anamnesis. The period from the onset of complaints until diagnosis had been established, was on the average 14.4 months with the 7 patients under investigation (average age 29 years, 4 female/3 male). In view of the fact that all the patients reported here were late cases, the results of the combined drug and surgical removal of foci (filling of the surgical cavities with spongiosa) must be classified as good. One knee joint had to be stiffened by operation. There were no reactivations within an average followup period of 3 years.

摘要

任何病因引起的髌骨病灶都非常罕见。从1955年到1979年底,我院有9例患者接受了髌骨手术。其中7例患者患有结核病,1例患者患有慢性非特异性骨髓炎,1例患者无论从组织学还是细菌学方面,我们都无法明确病灶的潜在病因。所有结核病灶,其中1个已侵入膝关节,均位于髌骨体部。在一名10岁女孩中,整个髌骨都被结核病灶感染。在前后位X线片上,病灶主要呈圆形。其直径在6至25毫米之间。在其中一个病灶中,有两个死骨明显可见,另一名患者有一个死骨。6例患者同时患有活动性器官结核,或在问诊时报告有特定疾病。从出现症状到确诊的时间,7例受调查患者平均为14.4个月(平均年龄29岁,4名女性/3名男性)。鉴于这里报告的所有患者都是晚期病例,联合药物和手术切除病灶(用松质骨填充手术腔)的结果必须被归类为良好。有一个膝关节不得不通过手术使其僵硬。在平均3年的随访期内没有复发。

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