大收肌腱重建内侧髌股韧带治疗青少年复发性髌骨脱位  

Reconstruction of medial patellofemoral ligament with transposition of great adductor muscular tendon for the treatment of teenagers' recurrent patellar dislocation

作　　者：邵川强[1] 陈长春[1] 赵春成 杨红梅[1] 康彦忠 SHAO Chuan-qiang CHEN Chang-chun ZHAOChun-cheng YANG Hong-mei and KANG Yan-zhong.(The Second Department of Orthopaedics ,Baoji Central Hospital,Baoji 721008 ,Shaanxi, China)

机构地区：[1]宝鸡市中心医院骨二科,陕西宝鸡721008

出　　处：《中国骨伤》2017年第6期557-560,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的 :探讨大收肌腱转位重建内侧髌股韧带(MPFL)治疗青少年复发性髌骨脱位(RDP)的手术方法和临床疗效。方法:自2012年5月至2014年9月,收治复发性髌骨脱位患者19例,其中男6例,女13例;年龄13~17岁,平均16岁;病程3~18个月,平均6个月。所有患者行大收肌腱转位重建内侧髌股韧带。比较手术前后Lysholm评分、外侧髌股角及Q角变化情况。结果:所有患者获得随访,时间12~18个月,平均16.5个月。术后切口均Ⅰ期愈合。无膝关节疼痛、肿胀,髌骨脱位或半脱位发生。外侧髌股角由术前的(-3.8±4.9)°恢复到术后的(10.3±4.1)°;Q角由术前的(16.4±3.1)°减小至术后的(10.5±1.2)°;Lysholm评分由术前的(68.6±8.5)分提高至末次随访的(93.7±6.5)分,其中优15例,良3例,可1例。结论:采用大收肌腱转位重建内侧髌骨韧带可明显恢复髌骨稳定性,是治疗青少年复发性髌骨脱位的有效的方法之一。Objective：To investigate surgical method and clinical curative effects of medial patellofemoral ligament（MPFL） reconstruction with great adductor muscular tendon in treating teenagers ＇ recurrent patellar dislocation. Methods：From May 2012 to September 2014,19 patients with recurrent dislocation of patellar,including 6 males and 13 females with an average of 16 years old（ranged from 13 to 17 years）,the courses of disease ranged from 3 to 18 months（averaged 6 months）.All patients were underwent great adductor muscular tendon transposition to reconstruct medial patellofemoral ligament. The curative effects were evaluated by preoperative and postoperative with Lysholm scores and Patellofemoral angle and Q angle.Results：All patients were followed up from 12 to 18 months with an average of 16.5 months. Primary healing was achieved at stage Ⅰ. No pain,swelling and patellar dislocation or subluxation occurred. Patellofemoral angle increased from preoperative（-3.8±4.9）° to（10.3±4.1）° postoperatively. Q angle decreased from preoperative（16.4±3.1）° to（10.5±1.2）° postoperatively;Lysholm scores were improved from preoperative（68.6±8.5） to（93.7±6.5） final follow up（P〈0.01）,and 15 cases got excellent results,3 good,and 1 fair. Conclusion：Reconstruction of medial patellofemoral ligament with transposition of great adductor muscular tendon could obviously recover stability of patellar,and it is one of the effective methods for the treatment of teenagers＇ recurrent patellar dislocation.

关 键 词：修复外科手术 髌韧带 髌骨脱位 复发 青少年 

分 类 号：R683.42[医药卫生—骨科学]