实用骨科杂志
實用骨科雜誌
실용골과잡지
JOURNAL OF PRACTICAL ORTHOPEDICS
2015年
4期
315-317,318
,共4页
陈长春%康彦忠%邵川强%赵春成
陳長春%康彥忠%邵川彊%趙春成
진장춘%강언충%소천강%조춘성
大收肌腱%内侧髌股韧带%髌骨脱位%青少年
大收肌腱%內側髕股韌帶%髕骨脫位%青少年
대수기건%내측빈고인대%빈골탈위%청소년
adductor muscular tendon%medial patellofemoral ligament%patella dislocation%teenager
目的：探讨大收肌腱转位重建内侧髌股韧带（medial patello femoral ligament，MPFL）治疗青少年复发性髌骨脱位（recurrent dislocation of patella，RDP）的手术方法和临床疗效。方法2011年4月至2013年7月，本院收治复发性髌骨脱位19例（20膝），其中男4例4膝，女15例16膝，年龄14~18岁，平均15.2岁。脱位次数2~4次。所有患者均行大收肌腱转位重建内侧髌股韧带术，术前、术后采用 Lysholm 评分及 Insall 标准评价膝关节功能。结果所有患者均获得随访，随访时间6~36个月，平均22个月。术后髌股关节稳定，无髌骨脱位再次发生。Lysholm 评分术前平均（61.6±4.0）分，术后（93.4±3.4）分（P <0.01）。术后疗效按 Insall 标准进行评价，优13例（13膝），良4例（5膝），可2例（2膝）。优良率为90.0%（18/20）。结论采用大收肌腱转位重建 MPFL 手术治疗 RDP 疗效可靠，手术创伤小，操作简单，康复快，可有效防止髌骨脱位的复发，值得临床推广。
目的：探討大收肌腱轉位重建內側髕股韌帶（medial patello femoral ligament，MPFL）治療青少年複髮性髕骨脫位（recurrent dislocation of patella，RDP）的手術方法和臨床療效。方法2011年4月至2013年7月，本院收治複髮性髕骨脫位19例（20膝），其中男4例4膝，女15例16膝，年齡14~18歲，平均15.2歲。脫位次數2~4次。所有患者均行大收肌腱轉位重建內側髕股韌帶術，術前、術後採用 Lysholm 評分及 Insall 標準評價膝關節功能。結果所有患者均穫得隨訪，隨訪時間6~36箇月，平均22箇月。術後髕股關節穩定，無髕骨脫位再次髮生。Lysholm 評分術前平均（61.6±4.0）分，術後（93.4±3.4）分（P <0.01）。術後療效按 Insall 標準進行評價，優13例（13膝），良4例（5膝），可2例（2膝）。優良率為90.0%（18/20）。結論採用大收肌腱轉位重建 MPFL 手術治療 RDP 療效可靠，手術創傷小，操作簡單，康複快，可有效防止髕骨脫位的複髮，值得臨床推廣。
목적：탐토대수기건전위중건내측빈고인대（medial patello femoral ligament，MPFL）치료청소년복발성빈골탈위（recurrent dislocation of patella，RDP）적수술방법화림상료효。방법2011년4월지2013년7월，본원수치복발성빈골탈위19례（20슬），기중남4례4슬，녀15례16슬，년령14~18세，평균15.2세。탈위차수2~4차。소유환자균행대수기건전위중건내측빈고인대술，술전、술후채용 Lysholm 평분급 Insall 표준평개슬관절공능。결과소유환자균획득수방，수방시간6~36개월，평균22개월。술후빈고관절은정，무빈골탈위재차발생。Lysholm 평분술전평균（61.6±4.0）분，술후（93.4±3.4）분（P <0.01）。술후료효안 Insall 표준진행평개，우13례（13슬），량4례（5슬），가2례（2슬）。우량솔위90.0%（18/20）。결론채용대수기건전위중건 MPFL 수술치료 RDP 료효가고，수술창상소，조작간단，강복쾌，가유효방지빈골탈위적복발，치득림상추엄。
Objective To investigate the surgical method and clinical curative effects of medial patellofemoral ligament (MPFL)reconstruction with great adductor muscular tendon transposition in the treatment of teenagers recurrent patellar dislo-cation. Methods From April 2011 to July 2013,nineteen patients(20 knees)with teenagers' recurrent patellar dislocation, age from 14 to 18 years old and had 2 to 4 times patellar dislocation,were admitted to our hospital. All the patients were treated with the surgery of great adductor muscular tendon transposition to reconstruct medial patellofemoral ligament. Furthermore,the knee function of these patients were evaluated with Lysholm grading and Insall standard before the surgery and after the surger-y. Results All the patients were followed up for 6 ~ 36 months with anaverage of 22 months,the patellar stability was restored and the recurrence of patellar dislocation was none in all cases. According to Lysholm,the average score before and after the surgery were 61. 6 ± 4. 0 and 93. 4 ± 3. 4(P < 0. 01)respectively. With Insall standard,the postoperative effects were as fol-lows:13 cases(13 knees)were excellent,4 cases(5 knees)were good and 2 cases(2 knees)were ordinary. Overall,the good rate was 90. 0% . Conclusion The surgery of treating RDP through the reconstruction of MPFL with great adductor mus-cular tendon transposition has the advantages of reliable effects,small incision,easy operation,quick recovery and the effective-ness of preventing the recurrence of the patellar dislocation. Therefore,it is worth clinical application.
