目的 对髌骨骨软骨骨折临床治疗结果进行分析,并回顾以往文献报告,总结该病的治疗、预后及治疗体会.方法 回顾性分析2005年9月～2010年9月该院收治的35例髌骨骨软骨骨折患者.均为闭合性骨折,并且为运动中髌骨一过性脱住受伤,所有病例均手术治疗,可吸收钉固定7例,PDS缝线固定3例,可吸收钉加PDS缝线固定24例,骨折块粉碎、压缩、无法固定而骨折块摘除1例,35例患者均行髌内侧支持带紧缩缝合术.随访骨折愈合及关节功能情况.结果 32例患者获得随访(可吸收钉固定5例,PDS缝线固定2例,可吸收钉及PDS缝线固定24例,骨折块摘除1例,3例失随访,随访时间6～41个月,平均25.9个月,31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 髌骨骨软骨骨折好发于青少年,应早期明确诊断、及时治疗,根据骨折块大小、位置及是否连同软骨下骨,行复位内固定术或骨块摘除,合并髌骨自发性脱位者应行髌内侧支持带紧缩术,以纠正髌骨轨迹,降低髌骨再脱位几率,降低创伤性关节炎的发生率.%[Objective] To review the clinical outcome of osteochondral fracture of patella. [Methods] From Sep. 2005 to Sep. 2010, 35 patients (male 14, female 21) with an average age of 15.6 years (range from 13-17 years) of osteochondral fracture of patella accepted operate treatment with absorbable screws and PDS chord. 7 cases received the operation with absorbable screws, 3 cases were PDS, 24 cases were absorbable screws and PDS simultaneously, and other 1 case was bone block extirpation. All 35 cases suffered patellar dislocation received medial patellar reti-naculum repaired. [Results] 32 patients were followed up (range from 6 to 41 months, average 25.9 months) and the other 3 cases were lost. Fracture unioned, pain disappeared, range of motion anastated in all cases of fracture fixed. [Conclusions] Osteochondral fracture of patella predilect adolescents, should be diagnosed, identified and treated promptly to lessen secondary injury. Cases suffering patellar dislocation should receive medial patellar retinaculum repaired simultaneously to lower the probability of redislocation of patella.
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