髌骨骨折的治疗现状

Current treatment of patella fractures

髌骨骨折是临床上常见的骨折之一。目前对于髌骨骨折的最佳治疗方式仍然存在争议。保守治疗适用于无明显移位伸膝结构完整的髌骨骨折,而手术指征为伸膝结构不完整或骨折分离移位>3 mm和关节面错位>2 mm的。张力带技术是应用最广泛的治疗方法,然而术后其内置物有很多并发症。其他治疗方法包括空心钉加张力带、Cable-Pin系统、钢板、小切口微创治疗和髌骨部分切除等。本文旨在对髌骨骨折治疗进行综述,帮助临床医师选择最好的治疗方式。

Patella fractures are one of the most common injures in orthopedics. At present, the optimal treatment of these fractures remains controversial. Nonsurgical management is indicated for nondisplaced fractures with an intact extensor mechanism. Surgical fixation is recommended for fractures that either disrupt the extensor mechanism or demonstrate 2 mm step-off and 3 mm of displacement of the bone fragments. Tension band fixation is the most commonly employed surgical technique;however, symptomatic hardware is the most common complication following operative treatment. Additionally, other surgical treatments for patellar fracture include cannulated screw tension band, Cable-Pin system, minimally invasive and percutaneous techniques and partial patellectomy. The purpose of this article is to review current treatment strategies to help optimize the management of patients with such patella fractures.