儿童套状髌骨骨折

Sleeve Fracture of the Patella in Children

小儿髌骨骨折较少见，然而小儿有一种特有的“套状髌骨骨折”，但国内尚无此类报道。作者共收治６例此种骨折，除２例外其余４例均为陈旧骨折，全部病例行切开复位，获得近期较好效果。作者指出误诊的原因是骨折远端多为软骨而骨质太少，故在Ｘ线片不易发现。诊断要点：张力性膝关节肿胀、高位髌骨和髌骨下套状骨块三大特征。

Injuries of the patella in children rarely caused comminution. Clinically, a sleeve fracture of the patella in children is relatively common. Since it is prone to be overlooked, there has been no report about this kind of injury in Chinese literatures. One fresh and four old sleeve fractures of the patella in children were encountered and treated surgically between 1988 and 1995 in Tianjin Hospital. All of the patients underwent open reduction and obtained short term satisfactory results. The authors emphasized that the fracture was frequently misdiagnosed on routine roentgenography due to the distal fractured fragment mainly composed of cartilage instead of bone. The tension swelling of the knee, high position of the patella and a sleeve fractured fragment in the distal patella may be the clues for establishment of a correct diagnosis.