CAJ | 학술논문

背景:成人复发性髌骨脱位由于不必考虑损伤骨骺的问题,多数采用骨移植,但在儿童复发性髌骨脱位采用骨移植并不适宜,多数学者采用软组织移植治疗. 目的:回顾性评估22例骨骺未闭儿童复发性髌骨脱位患者采用软组织移植治疗的临床效果. 方法:回顾性分析2006年5月至2009年4月上海长征医院关节外科采用软组织移植治疗儿童复发性髌骨脱位患者22例共29膝,分别在移植后3周,6周,3个月,1年和此后每年对患者进行随访,评估髌骨稳定性、主观症状以及患膝康复情况. 结果与结论:22例患者中1例复发,1例发生髌骨内侧脱位,其余患者均取得较好疗效.软组织移植前后膝关节功能主观评分分别为46.99±5.91与94.40±9.70(P<0.01),Lysholm膝关节功能综合评分在移植前后分别为44.37±4.49与90.10±11.00(P <0.01),移植后髌骨-滑车适配角由移植前(16.27±6.74)°改善为移植后(5.33±8.78)°(P <0.01),髌股外侧角由移植前(-1.92±7.64)°改善为移植后(11.95±3.99)°(P <0.01).软组织移植治疗骨骺未闭儿童复发性髌骨脱位,简单易行、可操作性强、疗效确切,有利于缓解症状,改善膝关节功能.
배경:성인복발성빈골탈위유우불필고필손상골후적문제,다수채용골이식,단재인동복발성빈골탈위채용골이식병불괄의,다수학자채용연조직이식치료. 목적:회고성평고22례골후미폐인동복발성빈골탈위환자채용연조직이식치료적림상효과. 방법:회고성분석2006년5월지2009년4월상해장정의원관절외과채용연조직이식치료인동복발성빈골탈위환자22례공29슬,분별재이식후3주,6주,3개월,1년화차후매년대환자진행수방,평고빈골은정성、주관증상이급환슬강복정황. 결과여결론:22례환자중1례복발,1례발생빈골내측탈위,기여환자균취득교호료효.연조직이식전후슬관절공능주관평분분별위46.99±5.91여94.40±9.70(P<0.01),Lysholm슬관절공능종합평분재이식전후분별위44.37±4.49여90.10±11.00(P <0.01),이식후빈골-활차괄배각유이식전(16.27±6.74)°개선위이식후(5.33±8.78)°(P <0.01),빈고외측각유이식전(-1.92±7.64)°개선위이식후(11.95±3.99)°(P <0.01).연조직이식치료골후미폐인동복발성빈골탈위,간단역행、가조작성강、료효학절,유리우완해증상,개선슬관절공능.
@@@@BACKGROUND:Adult recurrent patel ar dislocation is commonly treated with bone transplantation as it wil not consider the damage to the epiphysis, but it is not suitable for child recurrent patel ar dislocation, and most scholars choose the soft tissue transplantation to treat child recurrent patel ar dislocation. @@@@OBJECTIVE:To retrospectively evaluate the clinical treatment effect of soft tissue transplantation for the treatment of child recurrent patel ar dislocation with unclosed epiphysis in 22 cases. @@@@METHODS:Twenty-two patients (29 knees) with children recurrent patel ar dislocation selected from the Department of Joint Surgery, Shanghai Changzheng Hospital during May 2006 and April 2009 were retrospectively analyzed. The patients were treated with soft tissue transplantation, and fol owed-up at 3 and 6 weeks, 3 months and 1 year after transplantation, and every year thereafter. The patel ar stability, subjective symptoms and knee rehabilitation were evaluated. @@@@RESULTS AND CONCLUSION:Among the 22 patients, one case had recurrent patel ar dislocation, one case had medial patel ar dislocation, and the other cases obtained satisfactory effects. The subjective scoring of knee function before and after the soft tissue transplantation were 46.99±5.91 and 94.40±9.70, respectively (P<0.01), comprehensive Lysholm knee function score before and after soft tissue transplantation were (44.37±4.49) and (90.10±11.00) respectively (P<0.01), and the patel a-tackle congruence angle was changed from preoperative (16.27±6.74)° to postoperative (5.33±8.78)° (P<0.01), the lateral patel ofemoral angle was changed from preoperative (-1.92±7.64)° to postoperative (11.95±3.99)° (P<0.01). Soft tissue transplantation for the treatment of child recurrent patel ar dislocation with unclosed epiphysis has the advantages of easy to operation, strong operability and satisfactory effect, and it is beneficial to relief symptoms and to improve knee function.