髌骨骨软骨折的治疗

目的对髌骨骨软骨折临床治疗结果进行分析,并回顾以往文献报道,总结该病的治疗、预后及治疗体会。方法回顾性分析2005年9月—2010年9月收治的37例髌骨骨软骨折患者,男16例,女21例,年龄13～42岁,平均18.03岁,左侧20例,右侧17例,均为闭合性骨折,运动中髌骨一过性脱位受伤35例,交通伤2例(合并内侧副韧带及交叉韧带损伤)。所有病例均手术治疗,可吸收钉固定7例,PDS缝线固定3例,可吸收钉加PDS缝线固定24例,骨折块粉碎、压缩、无法固定而骨折块摘除3例,35例髌骨脱位致伤患者均行髌内侧支持带紧缩缝合术。随访骨折愈合及关节功能情况。结果 33例患者获得随访(可吸收钉固定5例,PDS缝线固定2例,可吸收钉及PDS缝线固定24例,骨折块摘除2例),4例失随访,随访时间6～41个月,平均23.6个月,31例内固定患者骨折均获得骨性愈合,关节活动度恢复正常范围,无明显疼痛症状及髌骨习惯性脱位现象。结论髌骨骨软骨折好发于青少年,应早期明确诊断、及时治疗,根据骨折块大小、位置及是否连同软骨下骨,行复位内固定术或骨块摘除,合并髌骨自发性脱位者应行髌内侧支持带修复,以纠正髌骨轨迹,降低髌骨再脱位几率,降低创伤性关节炎的发生率。

TREATMENT OF OSTEOCHONDRAL FRACTURE OF PATELLA

Objective To analyze the clinical outcome of osteochondral fracture of patella.To summarize treatment and prognosis by reviewing literatures,Methods From Sep.2005 to Sep.2010,37 patients(male 16,female 21) with an average age of 18.03 years(range 13-42) of osteochondral fracture of patella were accepted operate treatment with absorbable screws and PDS chord.7 cases were received the operation with absorbable screws,3 cases were PDS,24 cases were absorbable screws and PDS simultaneously,and other 3 case were bone block extirpation;All 35 cases suffered with patellar dislocation were received medial patellar retinaculum repaired.Results 33 patients were followed-up(range,6 to 41 months,average 23.6 months) and the other 4 cases were lost.All cases of fracture fixationed were fracture unioned,pain disappeared,range of motion anastated.Conclusion Osteochondral fracture of patella predilect adolescents,should be diagnosed identified and treated promptly to lessen secondary injury.Cases that suffered with patellar dislocation should be received medial patellar retinaculum repaired simultaneously to lower the probality of redislocation of patella.