Operative Orthopadie und Traumatologie · 2008
[Transosseous repair of patellar tendon ruptures].
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Dietz Sven-Oliver, Rommens Pol Maria, Hessmann Martin Henri
Аннотация
OBJECTIVE: Restoration of active knee extension. Restoration of active knee stabilization. Avoiding secondary patella alta.
INDICATIONS: Acute rupture of the patellar tendon within 3-5 days. Chronic rupture of the patellar tendon.
CONTRAINDICATIONS: Compromised general health status or associated injuries. Compromised local soft-tissue situation.
SURGICAL TECHNIQUE: Exposure of the ruptured tendon. Coronal drill hole through the distal third of the patella and coronal drill hole through the tibial tuberosity. After anatomic positioning of the patella (adjusting correct height), patellotibial fixation with monofil or woven (Labitzke) cerclage wire or PDS cord. Suture repair of the patellar tendon and repair of the ruptured medial and lateral retinaculum. Drain insertion. Wound closure in layers.
POSTOPERATIVE MANAGEMENT: Full load bearing in cylinder cast. Week 0-2: flexion restricted to 30 degrees , quadriceps muscle isometry. Week 2-4: flexion restricted to 60 degrees , strengthening of hip abductors and extensors. Week 4-6: flexion restricted to 90 degrees . After week 6: removal of cylinder cast. After week 12: return to sporting activities, removal of the cerclage wire.
RESULTS: Good results after surgical therapy. Low rate of secondary rupture. Low rate of muscle weakness.
INDICATIONS: Acute rupture of the patellar tendon within 3-5 days. Chronic rupture of the patellar tendon.
CONTRAINDICATIONS: Compromised general health status or associated injuries. Compromised local soft-tissue situation.
SURGICAL TECHNIQUE: Exposure of the ruptured tendon. Coronal drill hole through the distal third of the patella and coronal drill hole through the tibial tuberosity. After anatomic positioning of the patella (adjusting correct height), patellotibial fixation with monofil or woven (Labitzke) cerclage wire or PDS cord. Suture repair of the patellar tendon and repair of the ruptured medial and lateral retinaculum. Drain insertion. Wound closure in layers.
POSTOPERATIVE MANAGEMENT: Full load bearing in cylinder cast. Week 0-2: flexion restricted to 30 degrees , quadriceps muscle isometry. Week 2-4: flexion restricted to 60 degrees , strengthening of hip abductors and extensors. Week 4-6: flexion restricted to 90 degrees . After week 6: removal of cylinder cast. After week 12: return to sporting activities, removal of the cerclage wire.
RESULTS: Good results after surgical therapy. Low rate of secondary rupture. Low rate of muscle weakness.