髌骨下极骨折治疗的现状分析

Analysis of the treatment status of lower patellar pole fracture

髌骨远端1/4的骨折为髌骨下极骨折,约占髌骨骨折的9.3%~22.4%[1],可使伸膝装置连续性遭到破坏,影响膝关节的功能(图1)。髌骨下极骨折为关节外骨折[2],治疗上有其特殊性,因此笔者在简要介绍髌骨下极的解剖结构、生物力学特性及骨折机制的基础上,检索相关文献,综述髌骨下极骨折治疗的最新进展,分析目前治疗方式存在的问题,探讨未来研究方向。

To provide references for the treatment of lower patellar pole fracture through reviewing related literatures,analyzing the latest treatment progress as well as the existing problems.Advantages and disadvantages of the internal fixation methods for the treatment of patella lower pole fracture were analyzed and summarized through literature review,including partial patellectomy,tension band fixation,modified separate vertical wirings fixation,basket plate fixation,Nickel-titanium patellar concentrate(NT-PC)fixation and suture anchor fixation.Different surgical options may lead to various clinical results.Modified separate vertical wirings fixation was a simple,safe and effective treatment option,which can provide relatively better mechanical stability and clinical results based on literature review.Clinical effect of the surgery can be affected by many factors.More research is needed for a simpler,safer and more reliable surgical option in the treatment of patella lower pole fracture.