支帯切離とドリリングにて治療した有痛性分裂膝蓋骨の3例

概要

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Excision of the accessory ossification center in a painfull bipartite patella, which non-operative treatment failed to relieve symptoms, has been widely accepted. Patellar fragment, however, should be held, because most of the bipartite patella is left painless. Rohlederer reported a case of fusion of the bipartite fragment to the rest of the patelle following simple release of the lateral retinaculum. This is a report of three young people with tender painful bipartite patella (Saupe's III type) treated by reliese of the lateral retinaculum, partial separation of the insertion of the vastus lateralis from the superolateral patella, and drilling from the fragment to the rest of the patella. X-ray examination after surgery showed fusion of the fragment in two cases, but not in one case. All three cases, however, were painfree at full activities including sports. This surgical method decreases fraction force to the superolateral patella and compression force at the superolateral patellofemoral joint, which might improve the instability, aponeurositis, softening of the fragment, resulting in painfree knee.
西日本整形・災害外科学会の論文