青少年髌骨骨软骨骨折

Osteochondral fracture of the patella in adolescent

目的 探讨青少年髌骨骨软骨骨折的临床特征、诊治要点和手术疗效。方法 对14例青少年髌骨骨软骨骨折的临床资料进行分析。结果 平均随访26．2个月（11个月～4．5年），13例骨折愈合。膝关节功能完全恢复正常12例，膝关节疼痛、活动受限2例。结论 青少年髌骨骨软骨骨折易漏诊误诊，详细查体、髌骨轴位X线片及CT薄层扫描是防止漏诊最重要的手段。一经确诊应及早手术，切开复位、应用可吸收螺钉和缝线固定能满足固定要求且不需取内植物，是一种较理想的治疗方法。

Objective To investigate the clinical characteristics, diagnosis and surgical effect of osteochondral fracture of the patella in adolescent. Methods The clinical data of 14 cases with osteochondral fracture of patella in adolescent were analyzed. Results All cases were followed up for 26.2 months （ 11 ～ 54 months）. 13 cases got bony healing and 12 got complete function recovery; 2 were complicated with knee pain and motion limitation. Conclusions Osteochondral fracture of patella in adolescent is easy to be misdiagnosed. The most important way to prevent misdiagnosis is complete examination, axial patella roentgenography, and thin CT. Operation should be performed in cases whose diagnosis is confirmed. Open reduction and internal fixation with absorbable screw or suture is an ideal way, with which reoperation for implant removal can be avoided.