CAJ | 학술논문

目的对比观察手术方法和保守方法治疗急性髌骨脱位的临床效果.方法回顾性分析自2004年6月至2009年10月手术治疗和保守治疗急性髌骨脱位患者的临床资料,其中手术组18例,保守组17例,记录再脱位的病例数,CT测量髌骨外移度及髌骨倾斜角并以Kujala评分进行膝关节功能评估.结果所有患者均随访12个月以上.(1)手术组无再脱位病例,保守组有7例(41.2％)发生再脱位,两组比较差异有统计学意义(x2=9.265,P=0.002).(2)术后随访两组患者髌骨倾斜角:手术组均恢复正常(100％),保守组仅8例(47.1％)恢复正常,两组比较差异有统计学意义(x2=10.980,P=0.001)；髌骨外移:手术组均恢复正常,保守组仅6例(35.3％)恢复正常,两组比较差异有统计学意义(x2 =7.667,P=0.006).(3)膝关节Kujala评分:手术组术后为(90±5)分,与术前比较[(58±6)分]有显著提高(=16.465,P＜0.01)；保守组术后为(72±6)分,与术前比较[(62±8)分]提高不明显(t=0.943,P＞0.05),术后组间比较手术组高于保守组,两组比较差异有统计学意义(t=12.256,P＜0.01).结论临床上对于急性髌骨脱位的治疗,手术方法能明显恢复髌骨稳定性,提高膝关节功能.
목적 대비관찰수술방법화보수방법치료급성빈골탈위적림상효과.방법 회고성분석자2004년6월지2009년10월수술치료화보수치료급성빈골탈위환자적림상자료,기중수술조18례,보수조17례,기록재탈위적병례수,CT측량빈골외이도급빈골경사각병이Kujala평분진행슬관절공능평고.결과소유환자균수방12개월이상.(1)수술조무재탈위병례,보수조유7례(41.2％)발생재탈위,량조비교차이유통계학의의(x2=9.265,P=0.002).(2)술후수방량조환자빈골경사각:수술조균회복정상(100％),보수조부8례(47.1％)회복정상,량조비교차이유통계학의의(x2=10.980,P=0.001)；빈골외이:수술조균회복정상,보수조부6례(35.3％)회복정상,량조비교차이유통계학의의(x2 =7.667,P=0.006).(3)슬관절Kujala평분:수술조술후위(90±5)분,여술전비교[(58±6)분]유현저제고(=16.465,P＜0.01)；보수조술후위(72±6)분,여술전비교[(62±8)분]제고불명현(t=0.943,P＞0.05),술후조간비교수술조고우보수조,량조비교차이유통계학의의(t=12.256,P＜0.01).결론림상상대우급성빈골탈위적치료,수술방법능명현회복빈골은정성,제고슬관절공능.
Objective To compare the clinical results of surgical and conservative treatment of acute patellar dislocations.Methods Retrospective analyzed the clinical data of 35 patients with acute patellar dislocations from June 2004 to October 2009,and divided the patients into 2 groups.One group with 18 patients underwent surgical treatments,and the other group with 17 patients underwent conservative treatments,record the number of relapses cases of both the two groups.A radiographic examination was performed in the evaluation of the patients,and the Kujala questionnaire was applied with the intention of analyzing the improvement of pain and quality of life.Results All patients were followed up for more than 12 months.(1) The conservative treatment group exhibited a higher number of recurrent dislocations (7 patients) (41.2％) than the surgical treatment group,which did not have any relapses (x2 =9.265,P =0.002).(2) The patellar tilt returned to normal in the surgical group,while 8 patients returned to normal in the conservative group,with statistical difference between groups (x2 =10.980,P =0.001).And the lateral shift ratio returned to normal in the surgical group,while 6 patients returned to normal in the conservative group,with statistical difference between groups(x2 =7.667,P =0.006).(3)The surgical treatment group obtained a significantly better mean score on the Kujala test than preoperative ((90 ± 5) vs.(58 ± 6),t =16.465,P ＜ 0.01) ; The conservative treatment group,compared with the preoperative,is not improved obviously ((72 ± 6) vs.(62 ± 8),t =0.943,P ＞ 0.05) ;Postoperative group comparison,surgical group was higher than that in conservative group,there was significant difference between two groups (t =12.256,P ＜ 0.01).Conclusion For acute patellar dislocation,surgical treatment can significantly restore patellar stability,improve the function of knee joint.