儿童髌骨套袖状撕脱骨折的诊治探讨

Diagnosis and treatment of sleeve fractures of patella in children

目的探讨儿童髌骨袖套状撕脱骨折早期诊断及治疗方法的选择。方法对收治的13例小儿患者,尽早明确诊断、选择切开复位克氏针张力带或可吸收线缝合固定,长腿石膏托固定4周,主动或CPM机器活动膝关节。按有关标准评定其疗效。结果术后X线片复查,骨折完全愈合,随访8个月～5年,膝关节功能恢复和髌骨发育良好。结论根据临床表现、计算机X线摄影或MRI可以早期明确诊断,尽早手术复位。强调术后功能锻炼和定期复查均是治疗该类疾病的关键。

Objective: To investigate the early diagnosis and the treatment of sleeve fractures of patella(SFP) in children. Method: A total of thirteen patients with SFP received open reduction and internal fixation with Kirschner wire and tension band or absorbable line. All knees began active or passive movement after 4 weeks' fixation with plaster bandage. The effect was evaluated by relevant knee joint scoring criterion.Result: According to the result from an follow-up period of 8 months to 5 years, all fractures healed well and knee joint function resumed well.Conclusion: Early diagnosis is important to the treatment of SFP and it can be achieved by the results of clinical manifestations, computed radiography and MRI. Postoperative functional exercises and re-examination are also the key factors to the treatment.