膝关节软骨下不全性骨折的放射学现状

А. P. Ivankov, P. Seliverstov
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引用次数: 0

摘要

膝关节软骨下应力不足性骨折是一种新型骨折,发生在年龄较大的人群(50-55岁)中,当暴露于弱化骨小梁的正常负荷时。在俄罗斯的资料来源中,很少有关于这种类型骨折的信息。这主要是因为最初世界和国内医学界将这种类型的病理学指定为“膝关节自发性骨坏死”。近年来,国外对该术语进行了修订,取而代之的是一个更合适的术语——“软骨下不全性骨折”。功能不全性骨折的病因是基于许多导致骨组织弱化的疾病和条件(骨质疏松症、胶原病、类风湿性关节炎、骨骼辐射后变化等)。诊断这种类型骨折的主要方法是磁共振成像,因为它能够在任何阶段(尤其是早期)检测骨折。根据现代概念,术语“骨坏死”和“软骨下功能不全性骨折”需要完全不同的治疗方法。在出现并发症的情况下,膝关节髁突功能不全的骨折可能会导致软骨下塌陷和继发性骨关节炎,从而导致患者残疾。鉴于这一医学问题的相关性,本综述的目的是显示有关该问题的文献数据的现状。
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Current Radiological Aspects of Subchondral Insufficiency Fracture of the Knee
   Subchondral stress insufficiency fracture of the knee is a new type of fracture that occurs in people of the older age group (from 50–55 years old) when exposed to a normal load on weakened bone trabeculae. In Russian sources, there is few information about this type of fracture. This is primarily due to the fact that initially the world and domestic medical communities designated this type of pathology as “spontaneous osteonecrosis of the knee”. In recent years, this term has been revised abroad and replaced by a more suitable one – “subchondral insufficiency fracture”. The etiology of insufficiency fracture is based on many diseases and conditions that lead to bone tissue weakening (osteoporosis, collagenosis, rheumatoid arthritis, post-radiation changes in bones, etc.). The main method for diagnosing this type of fracture is magnetic resonance imaging, since it is able to detect a fracture at any stage (especially at an early one). According to modern concepts, the terms “osteonecrosis” and “subchondral insufficiency fracture” require completely different approaches to the treatment. In the presence of complications, a fracture of insufficiency of the knee joint condyles threatens with subchondral collapse and secondary osteoarthritis, which leads to disability of a patient. Given the relevance of this medical problem, the aim of the review is to show the current state of literature data on the issue.
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