[1]贾岩波 任逸众** 赵嘎日达 孟晨阳 满达 张田宇① 郝记睿①.可吸收固定棒联合带线锚钉治疗伴有骨软骨骨折的创伤性髌骨脱位[J].中国微创外科杂志,2023,01(4):279-283.
 Jia Yanbo,Ren Yizhong,Zhao Garida,et al.Absorbable Fixation Rod and Threaded Anchor Screw for Traumatic Dislocation of Patella With Osteochondral Fracture[J].Chinese Journal of Minimally Invasive Surgery,2023,01(4):279-283.
点击复制

可吸收固定棒联合带线锚钉治疗伴有骨软骨骨折的创伤性髌骨脱位()
分享到:

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2023年4期
页码:
279-283
栏目:
临床研究
出版日期:
2023-04-25

文章信息/Info

Title:
Absorbable Fixation Rod and Threaded Anchor Screw for Traumatic Dislocation of Patella With Osteochondral Fracture
作者:
贾岩波 任逸众** 赵嘎日达 孟晨阳 满达 张田宇① 郝记睿①
(内蒙古医科大学第二附属医院运动医学中心,呼和浩特010000)
Author(s):
Jia Yanbo Ren Yizhong Zhao Garida et al.
Center of Sports Medicine, Second Hospital of Inner Mongolia Medical University, Hohhot 010000, China
关键词:
髌骨脱位可吸收固定棒锚钉软骨骨折
Keywords:
Patellar dislocationAbsorbable fixation rodAnchor screwCartilage fracture
文献标志码:
A
摘要:
目的探讨可吸收固定棒联合带线锚钉治疗伴有骨软骨骨折的创伤性髌骨脱位的临床疗效。方法回顾性分析2018年1月~2021年10月25例创伤性髌骨脱位导致骨软骨骨折合并内侧髌股韧带(medial patellofemoral ligament,MPFL)损伤的资料。用可吸收固定棒复位固定骨软骨骨折,带线锚钉缝合修复MPFL。术后用膝关节活动度、Lysholm和IKDC膝关节评分及Bostman髌骨骨折功能评分标准评判关节功能,用CT、MRI评价骨折愈合情况、髌骨位置、MPFL连续性及信号。结果术后随访12~18个月,平均14个月,无髌骨脱位复发。按Bostman髌骨骨折功能评分标准,优22例,良2例,差1例。术后12个月膝关节活动度、Lysholm评分、IKDC评分均较术前明显改善(均P=0.000)。影像学检查显示骨软骨损伤和MPFL愈合良好。结论对于合并髌骨骨软骨骨折的创伤性髌骨脱位,一期可吸收固定棒复位固定骨折块联合锚钉紧缩缝合MPFL临床疗效确切。
Abstract:
ObjectiveTo explore the clinical effect of absorbable fixation rod combined with threaded anchor screw in the treatment of traumatic dislocation of patella with osteochondral fracture.MethodsClinical data of 25 cases of osteochondral fracture combined with medial patellofemoral ligament (MPFL) injury caused by traumatic patellar dislocation from January 2018 to October 2021 were retrospectively analyzed. The osteochondral fracture was fixed with absorbable fixation rod, and MPFL was repaired with threaded anchor screw suture. The joint function was evaluated by knee joint range of motion, Lysholm and IKDC knee joint scores and Bostman functional scoring criteria for patellar fracture after operation. The imaging examinations (CT and MRI) were used to evaluate the fracture healing, patellar position, MPFL continuity and signal condition.ResultsAll the patients were followed up for 12-18 months, with an average of 14 months. No recurrence of patellar dislocation occurred. According to the Bostman functional scoring criteria for patellar fracture, 22 cases were excellent, 2 cases were good, and 1 case was poor. The range of joint motion, Lysholm score and IKDC score were all improved at 12 months after operation (all P=0.000). The imaging examinations showed that osteochondral injury and MPFL healed well.ConclusionFor traumatic dislocation of patella with patellar osteochondral fracture, clinical effect of primary fixation of fracture blocks with absorbable fixation rod and anchor screw tight suture is accurate.

参考文献/References:

[1]Johnson DS,Turner PG.Management of the firsttime lateral patellar dislocation.Knee,2019,26(6):1161-1165.
[2]Uimonen M,Ponkilainen V,Paloneva J,et al.Characteristics of osteochondral fractures caused by patellar dislocation.Orthop J Sports Med,2021,9(1):2325967120974649.
[3]Uimonen M,Ponkilainen V,Hirvinen S,et al.The risk of osteochondral fracture after patellar dislocation is related to patellofemoral anatomy.Knee Surg Sports Traumatol Arthrosc,2021,29(12):4241-4250.
[4]Lee BJ,Christino MA,Daniels AH,et al.Adolescent patellar osteochondral fracture following patellar dislocation.Knee Surg Sports Traumatol Arthrosc,2013,21:1856-1861.
[5]曹福洋,许建中,陆世涛,等.自体韧带与LARS人工韧带编织物重建前交叉韧带:骨隧道扩大值、韧带生长因子及膝关节功能的评价.中国组织工程研究,2022,26(21):3281-3290.
[6]高跃川,王歆峰,赵良春,等.改良锚钉置入角度和应用双滑轮技术治疗髌骨下极撕脱骨折.中国骨伤,2022,35(7):683-687.
[7]郭振中,程燕,王孟飞,等.关节镜辅助下改良三联术治疗复发性髌骨脱位的临床效果观察.河北医科大学学报,2018,39(1):39-43.
[8]Repo JP,Uimonen MM,Nevalainen MT,et al.Outcomes following the operative treatment of intraarticular fracture combined with medial patellofemoral ligament reconstruction after patellar dislocation.Knee Surg Relat Res,2022,34(1):21.
[9]Lin KM,James EW,Aitchison AH,et al.Increased tibiofemoral rotation on MRI with increasing clinical severity of patellar instability.Knee Surg Sports Traumatol Arthrosc,2021,29(11):3735-3742.
[10]Wu ZK,Dai ZZ,Sha L,et al.Diagnostic performance of mri versus ct in the evaluation of intraarticular osteochondral fracture in pediatric patients with acute traumatic lateral patellar dislocation.Orthop J Sports Med,2022,10(3):23259671221083585.
[11]Song SY,Kim TS,Seo YJ.Initial conservative treatment of osteochondral fracture of the patella following firsttime patellar dislocation.BMC Musculoskelet Disord,2020,21(1):617.
[12]Khan SA,Baghdadi S,Carey JL,et al.Osteochondral fractures after patellar dislocation:current concepts.J Am Acad Orthop Surg Glob Res Rev,2021,5(12):e21.00155.
[13]李铭章,陈广辉,王洪伟,等.经骨缝合手术治疗急性髌骨脱位合并髌骨软骨Peeloff损伤早期疗效观察.中国骨与关节损伤杂志,2021,36(2):123-126.
[14]曾学珠,范程,汤波,等.关节镜辅助下可吸收软骨钉固定急性髌骨脱位合并膝关节骨软骨骨折的临床疗效观察.生物骨科材料与临床研究,2021,18(6):27-30.
[15]Sessums P,Young P,Washington J.Optimizing outcomes in articulating (Kissing) patellofemoral joint osteochondral lesions: case report and review of the literature.J Am Acad Orthop Surg Glob Res Rev,2021,5(3):e00085.
[16]Jungesblut OD,Moritz M,Spiro AS,et al.Fixation of unstable osteochondritis dissecans lesions and displaced osteochondral fragments using new biodegradable magnesium pins in adolescents.Cartilage,2021,13(1 Suppl):302S-310S.
[17]孙宇,姚思成,杨杰,等.不吸收缝线穿骨修复治疗急性髌骨脱位合并髌骨骨软骨骨折的疗效观察.中国内镜杂志,2022,28(9):73-78.
[18]雷波,黄亚男,冯国英,等.小切口可吸收棒内固定治疗桡骨头骨折的疗效分析.中国骨与关节损伤杂志,2018,33(11):1208-1210.
[19]王远辉,万永鲜,叶里子,等.克氏针及可吸收棒内固定修复儿童肱骨髁上骨折:生物相容性比较.中国组织工程研究,2015,19(26):4218-4222.
[20]梁伟,黄亚男,雷波,等.撬拨复位联合第4代可吸收棒内固定治疗Mason Ⅱ、Ⅲ型桡骨头骨折疗效分析.中国骨与关节损伤杂志,2020,35(11):1212-1214.
[21]刘亚欧,吉浩宇.青少年急性与慢性髌骨脱位后内侧髌股韧带损伤特点的性别差异.西部医学,2022,34(8):1178-1181.

备注/Memo

备注/Memo:
基金项目:内蒙古医科大学“善学”人才培养计划项目(ZY0202028)**通讯作者,Email:ryzgzr@163.com ①(内蒙古医科大学,呼和浩特010110)
更新日期/Last Update: 2023-06-29