急性髌骨外侧脱位后内侧髌股韧带损伤模式及其与髌股关节主要解剖参数的相关性  

Injury patterns of medial patellofemoral ligament and correlations with primary anatomical factors of the patellofemoral joint after acute lateral patellar dislocation

作　　者：姜辉[1] 郑彦宏[1] 孙百胜[2] 刘禄明[2] 郑雷[2] 都基权[2] 

机构地区：[1]武警山东总队医院医务处,山东济南250014 [2]武警山东总队医院影像科,山东济南250014

出　　处：《医学影像学杂志》2017年第5期896-900,905,共6页Journal of Medical Imaging

摘　　要：目的分析急性髌骨外侧脱位后内侧髌股韧带(MPFL)损伤模式,及其与髌股关节主要解剖参数间的相关性。方法回顾性分析107例经临床证实的急性髌骨外侧脱位患者的MRI资料。所有病例均行常规MRI矢状面、冠状面和横断面T1WI、T2WI、脂肪抑制FSE双回波序列扫描,由2位影像科医师对其MRI图像资料进行分析。结果急性髌骨外侧脱位107例中,MPFL撕裂103例,损伤发生率为96.3%。其中MPFL部分撕裂44例,完全撕裂59例。按MPFL损伤部位分,单纯髌骨侧撕裂34例,单纯股骨侧撕裂44例,单纯体部撕裂3例,MPFL多发部位撕裂22例。MPFL损伤程度组间及MFPL损伤部位组间股骨滑车发育不良、髌骨高位和胫骨结节-股骨滑车沟距离(TT-TG)间距三大参数间差异均无统计学意义(P>0.05);而在MPFL损伤部位组间,与Wiberg C型髌骨者相比,Wiberg B型髌骨者更易于发生MPFL完全撕裂(P=0.042)。结论急性髌骨外侧脱位后MPFL撕裂极为常见,最易于发生股骨侧撕裂,其次为髌骨侧,再次为多发部位撕裂。MPFL损伤模式与股骨滑车发育不良、髌骨高位、TT-TG间距三大解剖参数间无相关性;Wiberg B型髌骨者更易于发生MPFL完全撕裂。Objective To evaluate the injury patterns of medial patellofemoral ligament （MPFL） and correlations with primary anatomical factors of patellofemoral joint after acute lateral patellar dislocation （LPD）. Methods MR images were obtained in 107 patients with acute LPD. Images were acquired and evaluated using standardised protocols. Results MRI demonstrated MP- FL injury in 103 （96.3%） patients. 44 and 59 cases were partial and complete MPFL tears, respectively. Injuries occurred at the isolated patellar insertion （PAT） in 34 cases, the isolated femoral attachment （FEM） in 44 cases and the isolated midsubstance （MID） in 3 cases. More than one site （COM） of injury was identified in 22 cases. No statistical differences of type of trochlear dysplasia, patellar height and tibia[ tuberosity-trochlear groove distance were identified between different injury patterns of MPFL （ P 〉 0.05 ）. Compared with Wiberg patellar type C, Wiberg patellar type B was predisposed to complete MPFL tear （ P = 0.042 ）. Conclusion MPFL is frequently injured after acute LPD. MPFL is most easily injured at the FEM, followed by the PAT, the COM again. Injury patterns of MPFL are not related with type of trochlear dysplasia, patellar height and TT-TG. Wiberg patellar type B predisposes to complete MPFL tear.

关 键 词：髌骨脱位 膝关节 内侧髌股韧带 磁共振成像 

分 类 号：R681[医药卫生—骨科学] R445.2[医药卫生—外科学]