伸直型膝关节僵直手术的各组织延长研究  

Investigation into Tissue Prolongation in the Operation of Extense Knee Joint Ankylosis

作　　者：赵雁[1] 杨占杰[1] 郭德亮[1] 袁勇[1] 

机构地区：[1]解放军第89医院,山东潍坊261000

出　　处：《临床军医杂志》2004年第6期97-98,共2页Clinical Journal of Medical Officers

摘　　要：目的　探讨延长膝关节局部组织对治疗伸直型膝关节僵直的可行性与价值。方法　术前 1个月行膝关节前方皮肤推拿、或扩张器扩张按摩 ;手术取膝关节外侧切口 ,切除部分挛缩的股中间肌、股内外侧肌纤维 ,皮瓣宽度要求在 15cm以上 ,将股直肌游离延长达 2 5～ 3 0cm ,凿除股骨干、股骨髁处骨痂隆起 ,髌骨外侧切开关节囊 ,股胫关节内粘连用长弯剪探入剪开 ,术后 2～ 3d固定 ,开始无痛锻炼。结果　 2 5例中2 3例一期愈合 ,2例功能稍差 ,膝关节活动范围 90～ 10 0°,其余膝关节伸直 0～ 5° ,屈曲 10 0～ 13 0°。结论　延长膝关节局部组织是治疗伸直型膝关节僵直可行和有效的治疗方法。Objective To investigate into the feasibility of local tissue prolongation in the operation of extense knee joint ankylosis and its value. Methods Massage or dilator was used onto the skin one month earlier before operation. The incision was made into the outside of the knee joint, and part fibers of the contracted vastus intermedius and vastus lateralis muscle were removed. The width of the skin flap was more than 15cm. The rectus femoris muscle was dissociated up to the length of 25～30cm, and the callus protuberant on the femoral stem and condyle was chiseled off. The articular capsule was incised outside the outboard patella, and then the conglutination in femur-tibia joint was scissored with a long curve scissor. The knee joint was fixed for two or three days before painless exercise.Results Out of 25 patients, 23 reached primary healing. All the patients' knee joints were able to extend in the range of 0～5° and to flex 100～130°except two patients. Conclusion It is a feasible and effective way to extense knee joint ankylosis that the local tissue in the joint is prolongated.

关 键 词：伸直型膝关节僵直 手术 延长 治疗 局部组织 股骨干 挛缩 结论 活动范围 要求 

分 类 号：R684[医药卫生—骨科学] R683[医药卫生—外科学]