Orava S, Taimela S, Kvist M, Karpakka J, Hulkko A, Kujala U
Hospital Meditori, Turku, Finland.
Knee Surg Sports Traumatol Arthrosc. 1996;4(4):206-11. doi: 10.1007/BF01567964.
Five cases of stress fracture of the patella in athletes are presented. Four of these occurred transversally in the lower part and one longitudinally in the lateral part of the patella. Three of the patients were females (endurance runner, high jumper, and orienteerer) and two males (volleyball and soccer player). The diagnosis was made 2-8 months from the onset of the symptoms. Conservative treatment was successful in only one patient; all others were treated surgically, with good end result. Drilling of the fracture line was performed twice with metal wire cerclage fixation, excision of the lateral fragment was carried out once, and a bone graft with K wires and cerclage compression (tension band) was performed once. In all cases the patellar retinaculum was intact, indicating a stress injury. Stress fracture of the patella is a rare overuse injury, and therefore difficulties and delays in the diagnosis and treatment may occur. In cases with delayed diagnosis we recommend operative treatment.
本文报告了5例运动员髌骨应力性骨折的病例。其中4例骨折线横向位于髌骨下部，1例纵向位于髌骨外侧。3例患者为女性（耐力跑运动员、跳高运动员和定向越野运动员），2例为男性（排球运动员和足球运动员）。从症状出现到确诊的时间为2至8个月。保守治疗仅1例成功；其他患者均接受了手术治疗，最终效果良好。对骨折线进行了两次钻孔并采用金属丝环扎固定，进行了一次外侧骨折块切除术，以及一次采用克氏针和环扎加压（张力带）的植骨术。所有病例中髌腱膜均完整，提示为应力性损伤。髌骨应力性骨折是一种罕见的过度使用性损伤，因此在诊断和治疗中可能会出现困难和延误。对于诊断延迟的病例，我们建议采取手术治疗。
