急性髌内侧支持带损伤关节镜下修复术的疗效  

Study on therapeutic effects of arthroscopic repair on medial patellar retinaculum acute injury

作　　者：任民[1] 甄平[1] 方玉军[1] 任小龙[1] 党晨珀[1] 候费祎 李慎松[1] 

机构地区：[1]兰州军区兰州总医院,甘肃兰州730050

出　　处：《中国骨伤》2017年第1期29-32,共4页China Journal of Orthopaedics and Traumatology

基　　金：甘肃省自然科学基金(编号:145RJZA045);2015全军后勤科研计划面上项目(编号:CLZ15J003)~~

摘　　要：目的:采用高频超声对急性髌内侧支持带损伤进行准确定位,利用定位点行髌内侧支持带修补术探讨其疗效。方法:回顾性分析2009年6月至2014年3月收治的急性髌骨脱位患者17例,男6例,女11例;年龄11~40岁,平均(16.2±6.2)岁;病史2周以内。术前均行髌内侧支持带的高频超声检查,并对韧带纤维不连续的点位做皮肤标示。5例髌内侧支持带自体部损伤者行关节镜下过线缝补;12例支持带自髌骨边缘止点撕脱者将锚钉固定在骨内,用锚钉自带线缝补。术前及随访18个月时,进行Kujala评分和CT测量髌骨倾斜角,查最大主动、被动屈膝度及髌骨恐惧症。结果:随访18个月后Kujala评分92.2±11.1,髌骨倾斜角(11.5±4.2)°,与受伤前差异无统计学意义。最大主动屈膝(133.5±4.2)°,与正常值无差异。最大被动屈膝(153.5±4.6)°,超声显示髌内侧支持带纤维连续。髌骨恐惧症1例,无髌骨不稳复发。结论:髌内侧支持带损伤在超声定位下完成了准确的定位和关节镜下的修补,术后制动时间短。随访18个月,膝关节功能满意,无髌骨不稳复发。Objective：To accurately define the injury position of medial patellar retinaculum with acute injury under the guiding of high frequency uhrasonography, and to study therapeutic effects of suture operation on medial patellar retinaculum in the injuried position. Methods： From June 2009 to March 2014, there were 17 patients with acute patellar dislocation, 6 males and 11 females with average age of （ 16.2±6.2 ） years old. The duration time of patellar dislocation was 2 weeks. Before operation, the medial patellar retinaculum of an patients were examined with the high frequency ultrasonography, and the skin with the noncontinuous fiber was iudicated as the surface mark under the high frequency ultrasonography. The injury position of medial retinaculum was in the middle of 5 patients who were treated with suture operation of arthroscopic medial retinaculum. The injury position was in the patellar edge in 12 patients who were treated with fixing bone anchor on patella and arthroscopic suture operation of medial retinaculum. The CT examination and Kujala scores, patellat tilt angle on CT film, measured maximal angles of passive or active knee flexion and apprehension test were observed before treatment and postoperative 18 months. Results：Eighteen months after treatment, Kujala scores were 92.2± 11.1 and patellar tilt angle were （11.5±4.2） °, and there was no statistical difference between post-operation and pre-operation. The difference between maximal angles of passive knee flexion （ 133.5±4.2 ） o and normal had no statistically significance. Maximal angles of active knee flexion were （153.5±4.6） °. Uhrasonography showed the continuous fiber of medial retinaculum. A patient showed positive apprehension test and no patient had the recurrence patella instability after operation. Conclusion：The injury position of medial patel partetinaculum was accurately shown by high frequency ultrasonography and treated with arthroscopic suture operation. Knee immobilization time after operation was sho

关 键 词：髌骨脱位 超声检查 创伤和损伤 关节镜 

分 类 号：R322.7[医药卫生—人体解剖和组织胚胎学]