背景:佩吉特骨病是一种非恶性骨骼疾病,其特征是一个或多个骨骼部位的骨重建局灶性异常。在Paget病患者中,由轻微损伤引起的病理性骨折是众所周知的临床表现。胫骨结节的撕脱性骨折是一种罕见的损伤,在成人中发生率极低,文献中只有少数病例报道。我们描述了一个病人的情况下,与未诊断的佩吉特的骨病,胫骨结节的病理性撕脱性骨折。
方法:一名54岁的男性在足球比赛中站在球门区时膝盖让位后出现右膝疼痛,扭伤了他的右脚踝然后摔倒了.膝关节的X线平片显示胫骨结节的撕脱性骨折,胫骨近端一半的建模异常。MRI证实了Paget骨病的诊断。患者接受了切开复位内固定。随访3个月,患者的膝关节活动度在0~100度范围内良好,6个月后恢复了正常活动.
结论:我们描述了一例PDB成人胫骨结节撕脱性骨折的独特病例。空心螺钉和张力带接线治疗成功。PDB骨折患者存在诊断和手术挑战,在术后康复阶段谨慎进展至关重要。
BACKGROUND: Paget\'s disease of the bone is a non-malignant skeletal disorder characterized by focal abnormalities in bone remodelling at one or more skeletal sites. Pathological fractures occurring from trivial injuries are a well-known clinical presentation in patients with Paget\'s disease. An avulsion fracture of the tibial tuberosity is an infrequent injury and has an extremely low occurrence in adults, with only a few cases reported in literature. We describe a case of a patient with undiagnosed Paget\'s Disease of the bone, sustaining a pathological avulsion fracture of the tibial tuberosity.
METHODS: A 54-year-old male presented with right knee pain after his knee gave way whilst standing in the goal area during a game of football, twisting his right ankle and falling. Plain radiographs of the knee revealed an avulsion fracture of the tibial tuberosity with abnormal modelling of the proximal half of the tibia. An MRI confirmed a diagnosis of Paget\'s disease of the bone. The patient underwent open reduction internal fixation. At 3 months follow up, the patient had good knee range of motion from 0 to 100 degrees and by 6 months he had returned to his usual activities.
CONCLUSIONS: We describe a unique case of tibial tuberosity avulsion fracture in an adult with PDB. Treatment was successful with cannulated screws and tension band wiring. Patients with PDB who fracture present with diagnostic and operative challenges, it is vital to progress with caution in the postoperative rehabilitation phase.