Diagnosis And Treatment Experience Of Patella Osteocondral Fracture Fixation With Dissolvable Sutures

Objective： To sum up diagnosis of Patella osteochondralfracture and treatment experience of fixation with dissolvablesutures, which is Belong to intra-articular fractures, easily causemisdiagnosis or missed diagnosis due to clinical rare and difficult todiagnose,also adversely affects joint function even lead to severecompications such as traumatic arthritis.Methods: a set of clinical data analysis were retrospectivelyreviewed and obtained before and after arthroscopic diagnosis asPatella osteocondral fracture and fixation with dissolvable sutures.China-Japan Union Hospital in October2009on October-2011diagnosed as Patella osteochondral fracture were screened，4caseswere included,1males and3females; The mean age is21.25years(15-40years),7left and3right knee were examined. Preoperatively3cases were misdiagnosed and1case was diagnose.Among thesepatients1case twisted knee as walking down stairs,1case sprainher knee with high-heeled shoes,2cases fell down and hurt kneeswith flexion posture while fastly running.one of4cases complainedof habitual dislocation of patella.The mean time between traumahappening and clinic visiting is8days(3-18days).The sizes offractures varied:(2.0-3.0)cm×(2.0-2.5)cm. Each patient before andafter surgery was rated with Tegner and Lysholm knee score whichwere internationally recognized.Meanwhile,the postoperativesymptoms and signs,effects on life and work were assessed. Results: All patients had no early complications. Allpatients were followed up after surgery,3patients for outpatientfollow-up,1patients received telephone follow-up.Follow-up timeis8.1~28.3(18.1±8.3). At press time,all patients have good kneejoint stability and return to normal life and work.Ache,swelling andlocking symptoms of joints disappear moreover range of motionafter12weeks recovers as well as the one of contralateral side.Lysholm score mproved from（31.00±11.60）before surgery to(84.00±6.92) after3months and （97.75±2.62）after6months.Tegner score mproved from（3.00±0.81）before surgery to(8.25±0.96) after3months and（9.25±0.50）after6months.After6months all patients gained excellent efficacy which account for100%.Conclusions: Although preoperative misdiagnosis rate israther high, Patella osteocondral fracture could be diagnosed byarthroscopy which also can aid in healing. fracture fixed withdissolvable sutures could avoid osteochondral defect,otheradvantages are safe,easy to operate,well fixation,low risk,obviousimprovement of symptoms with a100%excellent and good rate inshort term. The clinical efficacy of long-term treatment requiresfurther observation.