可吸收固定棒联合带线锚钉治疗伴有骨软骨骨折的创伤性髌骨脱位  

Absorbable Fixation Rod and Threaded Anchor Screw for Traumatic Dislocation of Patella With Osteochondral Fracture

作　　者：贾岩波[1] 任逸众[1] 赵嘎日达 孟晨阳 满达 张田宇 郝记睿 Jia Yanbo;Ren Yizhong;Zhao Garida(Center of Sports Medicine,Second Hospital of Inner Mongolia Medical University,Hohhot 010000,China)

机构地区：[1]内蒙古医科大学第二附属医院运动医学中心,呼和浩特010000 [2]内蒙古医科大学,呼和浩特010110

出　　处：《中国微创外科杂志》2023年第4期279-283,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：内蒙古医科大学“善学”人才培养计划项目(ZY0202028)。

摘　　要：目的 探讨可吸收固定棒联合带线锚钉治疗伴有骨软骨骨折的创伤性髌骨脱位的临床疗效。方法 回顾性分析2018年1月~2021年10月25例创伤性髌骨脱位导致骨软骨骨折合并内侧髌股韧带(medial patellofemoral ligament, MPFL)损伤的资料。用可吸收固定棒复位固定骨软骨骨折,带线锚钉缝合修复MPFL。术后用膝关节活动度、Lysholm和IKDC膝关节评分及Bostman髌骨骨折功能评分标准评判关节功能,用CT、MRI评价骨折愈合情况、髌骨位置、MPFL连续性及信号。结果 术后随访12~18个月,平均14个月,无髌骨脱位复发。按Bostman髌骨骨折功能评分标准,优22例,良2例,差1例。术后12个月膝关节活动度、Lysholm评分、IKDC评分均较术前明显改善(均P=0.000)。影像学检查显示骨软骨损伤和MPFL愈合良好。结论 对于合并髌骨骨软骨骨折的创伤性髌骨脱位,一期可吸收固定棒复位固定骨折块联合锚钉紧缩缝合MPFL临床疗效确切。Objective To explore the clinical effect of absorbable fixation rod combined with threaded anchor screw in the treatment of traumatic dislocation of patella with osteochondral fracture.Methods Clinical data of 25 cases of osteochondral fracture combined with medial patellofemoral ligament(MPFL)injury caused by traumatic patellar dislocation from January 2018 to October 2021 were retrospectively analyzed.The osteochondral fracture was fixed with absorbable fixation rod,and MPFL was repaired with threaded anchor screw suture.The joint function was evaluated by knee joint range of motion,Lysholm and IKDC knee joint scores and Bostman functional scoring criteria for patellar fracture after operation.The imaging examinations(CT and MRI)were used to evaluate the fracture healing,patellar position,MPFL continuity and signal condition.Results All the patients were followed up for 12-18 months,with an average of 14 months.No recurrence of patellar dislocation occurred.According to the Bostman functional scoring criteria for patellar fracture,22 cases were excellent,2 cases were good,and 1 case was poor.The range of joint motion,Lysholm score and IKDC score were all improved at 12 months after operation(all P=0.000).The imaging examinations showed that osteochondral injury and MPFL healed well.Conclusion For traumatic dislocation of patella with patellar osteochondral fracture,clinical effect of primary fixation of fracture blocks with absorbable fixation rod and anchor screw tight suture is accurate.

关 键 词：髌骨脱位 可吸收固定棒 锚钉 软骨骨折 

分 类 号：R687.3[医药卫生—骨科学]