不同状态下Q角对复发性髌骨脱位的临床意义  

CLINICAL SIGNIFICANCE OF Q-ANGLE UNDER DIFFERENT CONDITIONS IN RECURRENT PATELLAR DISLOCATION

作　　者：王志杰[1,2] 陈游[1] 李安平[1] 龙义 

机构地区：[1]中南大学湘雅二医院骨科长沙,410011 [2]晋江市医院骨科

出　　处：《中国修复重建外科杂志》2014年第1期17-20,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨不同状态下Q角对复发性髌骨脱位的临床意义。方法以2012年8月-2013年3月收治的复发性髌骨脱位女性患者10例(11膝)作为试验组,同期收治的单纯膝关节半月板损伤女性患者20例(20膝)作为对照组。分别测量试验组在伸直位、屈膝30°位(屈曲位)、手法纠正位和手术纠正位Q角,以及对照组伸直位及屈曲位Q角。对两组患者伸直位和屈曲位Q角,两位置Q角差值(伸直位Q角-屈曲位Q角),以及试验组手法纠正位和手术纠正位Q角进行比较。结果试验组伸直位、屈曲位Q角以及两位置Q角差值分别为(17.2±3.6)、(14.3±3.0)、(2.9±1.9)°,对照组分别为(15.2±3.4)、(14.4±3.5)、(0.8±1.7)°,两组间伸直位和屈曲位Q角比较差异均无统计学意义(P>0.05);但试验组两位置Q角差值显著大于对照组(t=3.253,P=0.003)。试验组手法纠正位和手术纠正位Q角分别为(19.8±3.4)°和(18.9±3.8)°,差异无统计学意义(t=2.193,P=0.053)。结论如女性患者伸直位Q角无明显增大,但屈曲位Q角较伸直位明显改变时,需考虑复发性髌骨脱位可能;对于女性复发性髌骨脱位患者可通过测量术前手法复位髌骨后的Q角,来评估是否需行远端重排术。Objective To investigate the clinical significance of Q-angle measuring under different conditions in female recurrent patellar dislocation female patients. Methods Between August 2012 and March 2013, 10 female patients （11 knees） with recurrent patellar dislocation were collected as trial group; 20 female patients （20 knees） with simple meniscus injury were collected as control group at the same time. Q-angle was measured in extension, 30° flexion, 30° flexion with manual correction, and surgical correction in the trial group, and only in extension and 30° flexion in the control group. Then the difference value of Q-angle between extension and 30° flexion （Q-angle in extension subtracts Q-angle in 30 flexion） were calculated. Independent sample t-test was used to analyze Q-angle degrees in extension, 30° flexion, and the changed degrees of 2 groups. The Q-angle between manual correction and surgical correction of the trial group was analyzed by paired t-test. Results The Q-angle in extension, Q-angle in 30° flexion, and difference value of Q-angle between extension and 30° flexion were （17.2 ± 3.6）, （14.3 ± 3.0）, and （2.9 ± 1.9）° in the trial group and were （15.2 ± 3.4）, （14.4 ± 3.5）, and （0.8 ± 1.7）° in the control group. No significant difference was found in Q-angle of extension or Q-angle of 30° flexion between 2 groups （P 〉 0.05）, but the difference value of Q-angle between extension and 30° flexion in the trial group was significantly larger than that in the control group （t=3.253, P=0.003）. The Q-angle in 30° flexion with manual correction and surgical correction in the trial group was （19.8 ± 3.4）° and （18.9 ± 3.8）° respectively, showing no significant difference （t=2.193, P=0.053）. Conclusion When a female patient’s Q-angle in 30° flexion knee changes obviously compared with Q-angle in extension position, recurrent patellar dislocation should be considered. For female patients with recurrent patellar dislocation, the preo

关 键 词：复发性髌骨脱位 Q角 诊断 女性患者 

分 类 号：R681.8[医药卫生—骨科学]