Felix IV-A假体周围骨折:1例报告和综述

Felix type IV-A knee periprosthetic fracture: A case report and literature review

摘要:

全膝关节置换术后（total knee arthroplasty, TKA）假体周围骨折已成为一个日益常见和具有挑战性的骨科问题。临床中 TKA 术后胫骨假体周围骨折较股骨远端以及髌骨骨折少见，胫骨结节骨折合并髌腱损伤则更为罕见，在文献中很少被描述，其诊断与治疗充满挑战性。本文介绍了 1 例 74 岁女性患者，右膝骨关节炎行 TKA 术后 4 年，因下楼摔伤致右胫骨结节骨折伴髌腱损伤，骨折类型为 Felix IVA 型。手术采用缝线桥固定骨折，并联合半腱肌腱环形重建髌腱，在固定骨折断端的同时修复膝关节伸膝装置。术后 10 个月随访，患者获得了完全主动的膝关节伸展功能，无伸膝迟滞。此外，本文对相关文献进行综述。

Abstract:

Periprosthetic fractures after total knee arthroplasty (TKA) have become a common complication, a challenging orthopedic problem. Periprosthetic fractures of the proximal tibia are less common than the distal femoral and patellar fractures, the tibial tubercle frac- tures combined with patellar tendon injuries are even rarer in clinical practice, which are rarely described in the medical literature, and their diagnosis and treatment remain a challenge. This paper describes a 74-year-old female with Felix type IV-A fracture of the right tibi- al tubercle with patellar tendon injury caused by a fall 4 years after TKA for right knee osteoarthritis. The fracture was fixed with an suturebridge, and the patellar tendon was reconstructed with semitendinous tendon transfer. The patient achieved full active knee extension with- out knee extension retardation 10 months after the revision surgery. In addition, relative literatures were reviewed in this article.