Multifragment fracture of the patellar apex with extensive loss of skin: A case report

Q4 Medicine

Trauma Case Reports Pub Date : 2024-06-07 DOI:10.1016/j.tcr.2024.101051

Mohammed Barrached, Aboubacar Lawan Abdou, Achraf Tebbaa el Hassali, Adnane Lachkar, Najib Abdeljaouad, Hicham Yacoubi

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Abstract

Introduction

Patella fractures account for 1 % of all skeletal fractures, and can interrupt the knee's extensor apparatus. They can also be serious if associated with a cutaneous opening. We report the case of a fracture of the tip of the patella with a large loss of cutaneous substance.

Case report

A 22-year-old man was admitted for the management of a left knee trauma following a motorcycle accident. Clinical examination revealed a large loss of skin substance on the anteromedial aspect of the knee, with exposed bone, pain and lack of extension of the left knee. Standard X-ray of the left knee showed an avulsion fracture of the tip of the patella. The patient underwent patellar tendon reconstruction using transosseous stitches, reinforced by a quadricipital tendon reversal plasty, and protected by steel-wire patellotibial cerclage. A medial gastrocnemius flap was used to cover the loss of skin substance. After a functional rehabilitation protocol, the functional results were satisfactory, with a full return to activity after six months.

Conclusion

The stability of osteosynthesis using quadricipital tendon reversal plasty and patellotibial cerclage allows mobilization and immediate weight-bearing. This may lead to better clinical results.

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髌骨顶端多段骨折伴大面积皮肤缺损：病例报告

导言髌骨骨折占所有骨骼骨折的 1%，可中断膝关节的伸展装置。如果伴有皮肤开口，情况也会很严重。我们报告了一例髌骨顶端骨折并伴有大量皮肤物质缺失的病例。病例报告一名 22 岁的男子因摩托车事故导致左膝外伤入院治疗。临床检查显示，膝关节前内侧皮肤物质大量脱落，骨头外露，左膝疼痛且无法伸展。左膝的标准X光片显示髌骨顶端撕脱性骨折。患者接受了经骨缝合的髌骨肌腱重建术，通过四肢肌腱翻转成形术进行了加固，并用钢丝髌胫骨环扎术进行了保护。腓肠肌内侧皮瓣用于覆盖失去的皮肤物质。结论：使用股四头肌腱翻转成形术和髌胫骨环形固定术进行骨合成的稳定性允许活动和立即负重。这可能会带来更好的临床效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Trauma Case Reports Medicine-Emergency Medicine

CiteScore

0.60

自引率

0.00%

发文量

131

审稿时长

26 weeks

期刊介绍： Trauma Case Reports is the only open access, online journal dedicated to the publication of case reports in all aspects of trauma care and accident surgery. Case reports on all aspects of trauma management, surgical procedures for all tissues, resuscitation, anaesthesia and trauma and tissue healing will be considered for publication by the international editorial team and will be subject to peer review. Bringing together these cases from an international authorship will shed light on surgical problems and help in their effective resolution.