成人髌骨骨软骨折的治疗

THERAPEUTIC EXPERIENCE FOR ADULTS PATELLA WITH OSTEOCHONDRAL FRACTURE

目的对成人髌骨骨软骨折临床治疗结果进行分析,总结该病的治疗体会。方法回顾性分析2005年9月—2010年11月收治的14例成人髌骨骨软骨折患者,男11例,女3例;年龄18～42岁,平均36.2岁。左侧9例,右侧5例,均为闭合性骨折,交通伤5例,运动伤8例,击打伤1例。所有病例均手术治疗,可吸收钉固定2例,PDS缝线固定5例,可吸收钉加PDS缝线固定1例,骨折块粉碎、压缩、无法固定而骨折块摘除6例。随访骨折愈合及关节功能情况。结果 10例患者获得随访(可吸收钉固定2例,PDS缝线固定3例,可吸收钉及PDS缝线固定1例,骨折块摘除4例),4例失随访,随访时间6周至41个月,平均21.3个月,6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。结论青少年为髌骨骨软骨折的高发人群,但近年成人外伤性髌骨骨软骨折呈上升趋势,应早期明确诊断、针对性治疗,降低创伤性关节炎的发生率。

Objective To review the clinical outcome of osteochondral fracture of patella of adults.Methods From Sep.2005 to Nov.2010,14 patients（11 male,3 female） with an average age of 36.2 years（range 18-42 years） of osteochondral fracture of patella were accepted operate treatment with absorbable screws and PDS chord.Two cases were received the operation with absorbable screws,five cases were PDS,one case were absorbable screws and PDS simultaneously,and other six cases were bone block extirpation.All of 14 cases suffered with patellar dislocation were received medial patellar retinaculum repaired.Results Ten of fourteen patients were followed-up（range,6 weeks to 41 months,average 21.3 months） and the other four 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.