关节镜辅助早期手术治疗创伤性髌骨脱位  

Instant surgery management of acute traumatic patellar dislocation assisted by arthroscopy

作　　者：刘铭[1] 刘松波[1] 王宇[1] 项良碧[1] 刘宪民[1] 

机构地区：[1]沈阳军区总医院骨科,辽宁沈阳110016

出　　处：《临床军医杂志》2016年第4期357-360,共4页Clinical Journal of Medical Officers

基　　金：辽宁省自然科学基金(2013020175);辽宁省科技攻关计划项目(2013225089)

摘　　要：目的探讨利用膝关节镜技术辅助治疗创伤性髌骨脱位的手术方法并评估其治疗效果。方法选择2009年10月至2012年10月沈阳军区总医院应用关节镜治疗创伤性髌骨脱位的26例患者为研究对象。其中,男性10例,女性16例;复发性髌骨脱位22例。术前行X线、三维CT及MR等影像学检查,评估髌股关节形态学变异及损伤情况。先行膝关节镜检查,处理关节内合并损伤,清除关节内积血、游离的软骨及骨碎片,镜下可以清楚观察髌内侧及髌骨下极骨软骨损伤及内侧支持带损伤情况,同时处理并存的半月板等关节内结构损伤。于镜下行髌外侧支持带松解完成关节镜操作,辅助小切口修复内侧支持带复合体稳定结构。结果平均随访24.2个月,术后均未出现髌骨再次脱位,膝关节屈伸膝活动度无明显受限,膝关节Lysholm评分优良,无髌骨弹响及不稳感,6~8周恢复日常生活及工作。结论关节镜辅助治疗创伤性髌骨脱位,安全可靠,值得推广。Objective To explore the surgery technique assisted by arthroscopy for traumatic patellar dislocation and evaluate the clinical effect. Methods A retrospective study was performed on 26 cases of patients with traumatic patellar dislocation received in the General Hospital of Shenyang Military Region from October 2009 to October 2012. There were 16 cases of female,10 cases of male and 22 cases of recurrent patellar dislocation. The X-ray,three-dimensional CT and MR imaging examination were performed preopera-tively,and the patellofemoral joint morphological variation and damage were evaluated. The intra-articular injuries such as fragments of cartilage or bone were removed and torn meniscus were treated in the meantime. Lateral retinaculum release might be completed while the torn of the medial construction structure was confirmed. Results All of the 26 patients received follow-ups for mean 24. 2 months. Among the 26 patients,there was no recurrent patellar dislocation or obviously limited knee flexion mobility,snapping patellar or insta-bility. The Lysholm＇ s score of knee joint was excellent. All of the patients regained original ability for normal life and work within 6 to 8 weeks. Conclusion Early treatment of acute traumatic patellar dislocation assisted by arthroscopic technique is safe and reliable, which is worth of being promoted.

关 键 词：髌骨脱位 髌内侧支持带 髌股韧带 髌外侧支持带 关节镜 

分 类 号：R687.3[医药卫生—骨科学]