| Objective To investigate the clinical effect of traumatic patella dislocation with avulsion fracture by medial retinaculum tightening combined with lateral patellar retinaculum.Methods Thirty adolescents of traumatic patellar dislocation with avulsion fracture were analyzed retrospectively from May 2018 to May 2021, and all patients were treated by medial retinaculum tightening combined with lateral patellar retinaculum under arthroscopy. The improvement of Kujala score, Lysholm knee score and IKDC score were evaluated after operation. The range of motion, patellar tilt angle, patellar congruence angle and patellar lateral displacement rate were recorded before operation, 6 months and 1 year after operation.Results ①All patients recovered well after operation, the position of patella was in anatomical reduction, the average follow-up time was 12.1 months (10-18 months), and no recurrent dislocation or subluxation occurred. ②Postoperative excellent and good rates of knee joint, Kujala score, Lysholm score and IKDC score all improved when compared with preoperative ones, from 3.3%, (45.3±2.2), (36.8±2.5) and (53.5±4.9) preoperatively to 93.3%, (92.9±2.2), (94.8±3.5) and (98.3±5.0) at 12 months postoperatively, and the differences between preoperation and postoperation showed statistical significance (P<0.05). ③The range of motion increased from (25.3±4.5) ° before operation to (125.4±3.2) ° at 12 months postoperatively, the patellar tilt angle patellar, congruence angle and patellar lateral displacement rate decreased respectively, from (12.5±1.8)°, (19.2±1.9)° and (18.5±2.3)% preoperatively to (5.6±0.7)°, (6.8±1.0)° and (6.9±0.8)% at 12 months postoperatively, and the differences between preoperation and postoperation showed statistical significance (P<0.05).Conclusion The treatment of traumatic patella dislocation with avulsion fracture by medial retinaculum tightening combined with lateral patellar retinaculum is safe and effective under arthroscopy, stable patellar trajectory can be obtained, and the imaging indexes and clinical function scores are satisfactory in the medium and short-term follow-up. |
