PMC10203210_01
(A,B) The anterior and lateral x-ray film of knee joint of affected limb; (C) The x-ray film of healthy knee joint before operation; (D,E) the postoperative anterolateral x-ray film of knee joint.
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F1
Tomography) examinations of the left knee joint after admission (Figures 1A-E). The Insall-Salvati ratio was 64.71/48.03 (1.35) and the diagnosis was "1.
PMC10203210_02
(A,B) The anterior and lateral x-ray film of knee joint; (C) complete rupture of patellar tendon; (D) after the continuity of patellar tendon was reconstructed, the fixation was completed; (E,F) the anterior and lateral x-ray films of knee joint after operation.
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F2
The Insall-Salvati ratio was 52.23/42.45 (1.23) and the diagnosis was "rupture of the right patellar tendon." Active preoperative preparation was made (Figures 2A-D), and the surgical treatment was selected after eliminating the contraindications.
(A) The patellar tendon is broken from the lower pole of the patella, and the lower pole is avulsion fracture; (B) make a small opening in the distal patellar tendon; (C) the T-shaped plate reversely passes through the orifice, and the transverse arm is hung on the patellar tendon; (D) the steel wire and suture pass through the transverse arm hole of the plate for use; (E) the suture "Z" weaves the distal patellar tendon and passes through the transverse arm hole of the plate for use; (F) fix the plate with screws after tightening the steel wire and knotting the suture; (G) the x-ray fluoroscopy showed good fixation and internal fixation.
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F3
Take the left knee anterior median incision through the surgical approach, cut the skin, subcutaneous tissue and deep fascia layer by layer, peel and expose the starting point of the patellar tendon at the lower pole of the patella, which shows a cap-like avulsion fracture, the patella moves up and the tension of patellar tendon disappears (Figure 3A). Tianjin Zhengtian Company, China) and shape it, then penetrate the steel wire to form the "anchor loop device", insert the sharp knife into the plate reversely at the opening of the patellar tendon (Figures 3B-D), hang the transverse arm of the plate on the patellar tendon and the lower pole of the patella, and pull the patellar tendon towards the proximal end to reduce the fracture, and see that the tension of the patellar tendon is restored, and the x-ray fluoroscopy machine shows that the plate has a good fit. Take the anchor nail suture, one suture is woven and sewn on both sides of the patellar tendon through the hole position of the plate transverse arm, and tighten the knot and fix it on the plate transverse arm; Take another suture and suture it in the "Z" shape in front of the patellar tendon and then pass through the transverse arm of the plate for standby (Figure 3E). Then pull the steel wire from both sides through the internal and external support belt and tighten it, tighten and fix the front two sutures on the plate transverse arm, and finally fix the bone plate with three screws (Figure 3F). It can be seen that the fixation is satisfactory, the intraoperative activity is good, the fracture fixation and patellar tendon tension are restored, and the x-ray fluoroscopy machine shows that the fracture reduction is satisfactory, and the internal fixation positioning is good (Figure 3G).