急性髌骨脱位后髌骨骨软骨骨折手术固定方法的研究进展
简介
这篇综述总结急性髌骨脱位后髌骨骨软骨骨折的手术固定策略，主要包括保留骨软骨碎块的复位内固定与碎块切除后软骨修复；前者可最大程度保留原生透明软骨和软骨下骨。内固定方式涵盖金属螺钉、缝线环扎/环周固定、生物可吸收固定及联合固定，各方法的适应证、优缺点不同。方案选择需依据骨软骨碎块的大小、位置和质量，以改善手术效果并减少并发症；组织工程联合再生医学被视为难治性骨软…
英文摘要
OBJECTIVE: To review the research progress on fixation methods for patellar osteochondral fractures (OCFs) following acute patellar dislocation. METHODS: The domestic and foreign literature concerning the surgical fixation of patellar OCFs after acute patellar dislocation in recent years was extensively reviewed. The advantages, disadvantages, and indications of various surgical treatment methods were summarized. RESULTS: Acute patellar dislocation is frequently complicated by patellar OCFs, which significantly impair patients' quality of life. Current surgical management of patellar OCFs primarily consists of two major strategies: reduction and internal fixation preserving the osteochondral fragment, and cartilage repair following fragment removal. Surgical reduction and internal fixation can maximally preserve the native hyaline cartilage and subchondral bone, holding significant importance for treating fragments that are difficult to repair. Internal fixation techniques include metal screw fixation, suture cerclage/circumferential fixation, bioabsorbable fixation, and combined fixation methods. The indications, advantages, and disadvantages of each surgical fixation method vary. Selecting an appropriate treatment regimen is crucial for clinical prognosis. Moreover, tissue engineering combined with regenerative medicine represents a promising synergistic strategy for integrated repair of refractory osteochondral defects. CONCLUSION: There are various surgical fixation methods for patellar OCFs resulting from acute patellar dislocation. To enhance surgical outcomes and reduce postoperative complications, the most suitable treatment strategy should be selected based on the size, location, and quality of the osteochondral fragment.