留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

带线锚钉缝合固定治疗髌骨软骨骨折的疗效

余敏 丑克 李雨佳

余敏, 丑克, 李雨佳. 带线锚钉缝合固定治疗髌骨软骨骨折的疗效[J]. 昆明医科大学学报, 2022, 43(2): 107-111. doi: 10.12259/j.issn.2095-610X.S20220202
引用本文: 余敏, 丑克, 李雨佳. 带线锚钉缝合固定治疗髌骨软骨骨折的疗效[J]. 昆明医科大学学报, 2022, 43(2): 107-111. doi: 10.12259/j.issn.2095-610X.S20220202
Min YU, Ke CHOU, Yujia LI. Effect of Repairing Patellar Cartilage Fracture with Suture Anchor[J]. Journal of Kunming Medical University, 2022, 43(2): 107-111. doi: 10.12259/j.issn.2095-610X.S20220202
Citation: Min YU, Ke CHOU, Yujia LI. Effect of Repairing Patellar Cartilage Fracture with Suture Anchor[J]. Journal of Kunming Medical University, 2022, 43(2): 107-111. doi: 10.12259/j.issn.2095-610X.S20220202

带线锚钉缝合固定治疗髌骨软骨骨折的疗效

doi: 10.12259/j.issn.2095-610X.S20220202
基金项目: 湖南省卫生健康委科研基金资助项目(20201318)
详细信息
    作者简介:

    余敏(1979~),男,湖南长沙人,博士,副主任医师,研究方向:骨关节疾病及运动损伤

  • 中图分类号: R684.7

Effect of Repairing Patellar Cartilage Fracture with Suture Anchor

  • 摘要:   目的  研究带线锚钉固定修复髌骨软骨骨折的临床效果。  方法  选取2016年7月至2018年6月髌骨软骨骨折病例50例,其中男18例,女32例,年龄17~28岁,均为外伤致急性髌骨外侧脱位伴髌骨软骨骨折,术前Lysholm评分为(63.8±7.2),VAS评分为(8±1.7)。均采取带线锚钉缝合固定方法修复髌骨软骨骨折。  结果  术后所有患者伤口愈合良好,无膝关节肿胀及积液,髌骨软骨愈合良好,锚钉无松动、脱出,软骨块无移位。除3例患者术后6周时股四头肌轻度萎缩,肌肉力量恢复欠佳,其他患者下肢肌肉力量均恢复良好。Lysholm评分(87.3±4.1),VAS评分(2±2.3 ),均较术前明显改善(P < 0.05)。  结论  采取带线锚钉缝合固定髌骨软骨骨折,手术操作简单,能有效固定软骨骨折,避免刺激髌前滑囊,有其独特优势。
  • 图  1  关节镜下观察

    a:关节镜下观察:关节镜下髌骨软骨骨折情况 ; b:修复前大体情况:髌骨软骨缺损区局部清创及软骨骨折块; c:修复后:带线锚钉缝合固定软骨骨折 ; d:修复后关节镜下复位情况 。

    Figure  1.  Arthroscopic observation

    图  2  术后复查

    a:术后复查:术后正侧位X线; b:术后复查:术后CT。

    Figure  2.  Postoperative re-examination

    表  1  术前及术后Lysholm评分及VAS评分[($\bar x \pm s $),分]

    Table  1.   Preoperative and postoperative Lysholm score and VAS score [($\bar x \pm s $),score]

    组别Lysholm评分VAS评分
    术前 63.8 ± 6.2 8 ± 1.7
    术后 87.3 ± 4.5 2 ± 2.1
    P 0.01 0.03
    下载: 导出CSV
  • [1] Franzone J M,Vitale M A,Stein B E S,et al. Is there an association between chronicity of patellar instability and patellofemoral cartilage lesions. An arthroscopic assessment of chondral injury[J]. J Knee Surg,2012,25(5):411-416. doi: 10.1055/s-0032-1313747
    [2] Stanitski C L,Paletta G A Jr. Articular cartilage injury with acute patellar dislocations in adolescents:arthroscopic and radiologic correlation[J]. Am J Sports Med,1998,26(1):52-55. doi: 10.1177/03635465980260012501
    [3] Callewier A,Monsaert A,Lamraski G. Lateral femoral condyleostechondral fracture combined to patellar dislocation:a case report[J]. Orthop Traumatol Surg Res,2009,95(1):85-88. doi: 10.1016/j.otsr.2008.07.001
    [4] Morris J K,Weber A E,Morris M S. Adolescent femoral chondral fragment fixation with poly-l-lactic acid chondral darts[J]. Orthopedics,2016,39(2):362-366. doi: 10.3928/01477447-20160129-05
    [5] Beran M C,Samora W P,Klingele K E. Weight-bearing osteochondral lesions of the lateral femoral condyle following patellar dislocation in adolescent athletes[J]. Orthopedics,2012,35(7):1033-1037. doi: 10.3928/01477447-20120621-16
    [6] Nomura E,Inoue M,Kurimura M. Chondral and osteochondral injuries associated with acute patella dislocation[J]. Arthroscopy,2003,19(7):717-721. doi: 10.1016/s0749-8063(03)00401-8
    [7] Lubis A M,Sandhow L,Lubis V K A,et al. Susanto. Isolation and cultivation of mesenchymal stem cells form iliac crest bone marrow for further cartilage defect management[J]. Acta Med Indones,2011,43(3):178-184.
    [8] Shah M R,Kaplan K M,Meislin R J,et al. Articular cartilage restoration of the knee[J]. Bull,NYU Hosp Jt Dis,2007,65(1):51-60.
    [9] Hawkins R J,Bell R H,Anisette G. Acute patellar dislocations:the natural history[J]. Am J Sports Med,1986,14(2):117-120. doi: 10.1177/036354658601400204
    [10] Cash J D,Hughston J C. Treatment of acute patellar dislocation[J]. Am J Sports Med,1988,16(3):244-249. doi: 10.1177/036354658801600308
    [11] Salonen E E,Magga T,Sillanpää P J,et al. Traumatic patellar dislocation and cartilage injury:A follow-up study of long-term cartilage deterioration[J]. Am J Sports Med,2017,45(6):1376-1382. doi: 10.1177/0363546516687549
    [12] Gesslein M,Merkl C,Bail H J,et al. Refixation of Large Osteochondral Fractures After Patella Dislocation Shows Better Mid to Long Term Outcome Compared With Debridement[J]. Cartilage,2019,13:1-8. doi: 10.1177/1947603519886637
    [13] Bauer K L. Osteochondral injuries of the knee in pediatric patients[J]. J Knee Surg,2018,31(5):382-391. doi: 10.1055/s-0038-1625956
    [14] Lidder S,Thomas M,Desai A,et al. Osteochondral fractures of the knee in skeletally immature patients:short term results of operative fixation using omnitech screws[J]. Acta Orthop Belg,2016,82(4):762-767.
    [15] Kang H,Li J,Chen X X,et al. Fixation versus excision of osteochondral fractures after patellar dislocations in adolescent patients:A retrospective cohort study[J]. Chin Med J (Engl),2018,131(11):1296-1301. doi: 10.4103/0366-6999.232800
    [16] Fu F H,Zurakowski D,Browne J E,et al. Autologous chondrocyte implantation versus debridement for treatment of full thickness chondral defects of the knee:an observational cohort study with 3-year follow-up[J]. Am J Sports Med,2005,33(11):1658-1666. doi: 10.1177/0363546505275148
    [17] Kruez P C,Steinwachs M R,Erggelet C,et al. Results after microfracture of full-thickness chondral defects in different compartments of the knee[J]. Osteoarthritis Cartilage,2006,14(11):1119-1125. doi: 10.1016/j.joca.2006.05.003
    [18] Gillogly S D,Arnold R M. Autologous chondrocyte implantation and anteromedialization for isolated patellar articular cartilage lesions:5- to 11-year follow-up[J]. Am J Sports Med,2014,42(4):912-920. doi: 10.1177/0363546513519077
    [19] Gomoll A H,Gillogly S D,Cole B J,et al. Autologous chondrocyte implantation in the patella:a multicenter experience[J]. Am J Sports Med,2014,42(5):1074-1081. doi: 10.1177/0363546514523927
    [20] Lubis A M T,Panjaitan T,Hoo C. Autologous mesenchymal stem cell application for cartilage defect in recurrent patellar dislocation:A case report[J]. Int J Surg Case Rep,2019,55:183-186. doi: 10.1016/j.ijscr.2019.01.031
    [21] Moseley J B Jr,Anderson A F,Browne J E,et al. Long term durability of autologous chondrocyte implantation:a multicenter,observational study in US patients[J]. Am J Sports Med,2010,38(2):238-246. doi: 10.1177/0363546509348000
    [22] Peterson L,Vasiliadis H S,Brittberg M,et al. Autologous chondrocyte implantation:a long-term follow-up[J]. Am J Sports Med,2010,38(6):1117-1124. doi: 10.1177/0363546509357915
    [23] Argawala S,Mohrir G S,Mahajan B S. Osteochondral fracture lateral femoral condyle treated with ORIF using Z-Plasty:a modification of Coonse and Adams approach[J]. Case Rep Orthop,2011,95:191-196. doi: 10.1155/2011/957196
    [24] Song K S,Min B W,Bae K C,et al. Chondral fracture of the lateral femoral condyle in children with different treatment methods[J]. J Pediatr Orthop B,2016,25(1):43-47. doi: 10.1097/BPB.0000000000000222
    [25] Chan C M,King J 3rd,Farmer K W. Fixation of chondral fracture of the weight-bearing area of the lateral femoral condyle in an adolescent[J]. Knee Surg Sports Traumatol Arthrosc,2014,22(6):1284-1287. doi: 10.1007/s00167-013-2833-0
    [26] Arendt E A,Dejour D,Farr J. Patellofemoral instability[J]. Sports Med Arthrosc,2012,20(3):127. doi: 10.1097/JSA.0b013e318262a0ce
    [27] Millington K L,Shah J P,Dahm D L,et al. Bioabsorbable fixation of unstable osteochondritis dissecans lesions[J]. Am J Sports Med,2010,38(10):2065-2070. doi: 10.1177/0363546510371369
    [28] Paša L,Veselý R,Kočiš J,et al. Treatment of Extensive Chondral Defects of the Patella after Patellar Dislocation[J]. Acta Chir Orthop Traumatol Cech,2017,84(6):441-447.
  • [1] 姚敬宇, 韦睿, 张琳, 石胜柳, 白鹏.  外周血中NLR、PLR、FRA对骨折后骨质正常和骨质减少的影响, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20241117
    [2] 何光雄, 潘斯学, 吴娟, 向俊宜, 卢钰, 保超宇.  第5跖骨近端骨折髓内钉设计的影像学测量, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20230108
    [3] 鲁月, 邱昌明, 杨云丽, 黄治国, 李治贵, 麻伟青, 李娜.  超声引导下右美托咪定作为佐剂的罗哌卡因单次收肌管阻滞用于成人髌骨骨折术后镇痛的效果, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220613
    [4] 贾进, 侯开宇, 陈仲, 胡性喜, 郑常友, 蒋俊良.  间断垂直不可吸收缝线联合尼斯结治疗髌骨下极骨折22例, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220505
    [5] 何川, 舒永德, 杨腾云, 李彦林, 王福科, 何任杰, 钟瑞颖, 陈广超.  微骨折术治疗距骨骨软骨损伤在不同MRI分期患者中的疗效对比, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20210513
    [6] Ridhinath Prasad Mandal, 向耀宇, 李青, 吴迪.  弹性髓内钉治疗儿童尺桡骨双骨骨折45例(英文), 昆明医科大学学报.
    [7] 张健, 赵养学, 李德成, 赵江, 赵宇, 白蓉.  Zina和Sextannt微创椎弓根螺钉系统治疗胸腰段骨折的临床效果, 昆明医科大学学报.
    [8] 李进涛, 郑红, 李波, 袁鑫, 唐薇, 赵宏斌.  恒古骨伤愈合剂对骨质疏松骨折树鼩雌二醇和骨代谢的影响, 昆明医科大学学报.
    [9] 陈斌, 陈洁, 徐永清, 张颖, 王成勇, 丁晶.  膝关节后脱位并胫骨平台前缘骨折25例报道, 昆明医科大学学报.
    [10] 赵亮.  后路微“八”式跨伤椎椎弓根钉植入短节段固定治疗胸腰段骨折, 昆明医科大学学报.
    [11] 周建平.  髌骨复位固定器治疗髌骨骨折疗效观察, 昆明医科大学学报.
    [12] 张雷.  双切口结合重建锁定钢板固定治疗肩胛骨骨折17例, 昆明医科大学学报.
    [13] 陆晓涛.  老年股骨粗隆间骨折不同内固定手术疗效分析, 昆明医科大学学报.
    [14] 夏英杰.  SD大鼠髁状突颈部骨折对大鼠髁状突软骨细胞增殖与凋亡的影响, 昆明医科大学学报.
    [15] 孙淑霞.  单排螺旋CT扫描技术在足踝小关节外伤中的应用, 昆明医科大学学报.
    [16] 王叶武.  经后外或后内侧入路治疗胫骨平台后髁骨折15例分析, 昆明医科大学学报.
    [17] 胡加绍.  胫骨平台双髁骨折42例治疗分析, 昆明医科大学学报.
    [18] 后路钉-棒系统治疗胸腰椎不稳定性骨折108例疗效分析, 昆明医科大学学报.
    [19] 后路椎弓根钉棒系统治疗胸腰椎骨折106例临床分析, 昆明医科大学学报.
    [20] 吉建华.  46例老年股骨颈骨折患者的术前术后护理体会, 昆明医科大学学报.
  • 加载中
图(2) / 表(1)
计量
  • 文章访问数:  3081
  • HTML全文浏览量:  1996
  • PDF下载量:  22
  • 被引次数: 0
出版历程
  • 收稿日期:  2021-07-09
  • 网络出版日期:  2022-01-25
  • 刊出日期:  2022-03-04

目录

    /

    返回文章
    返回