改良“3Z”成形术治疗低位髌骨  

Modified"3Z"plasty for the treatment of patella baja

作　　者：马腾[1] 黄强[1] Ma Teng;Huang Qiang(Lower extremity Ward,Skeletal Trauma Hospital,the Affiliated Honghui Hospital of Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]西安交通大学附属红会医院骨创伤医院下肢病区,710054

出　　处：《美中国际创伤杂志》2022年第1期49-52,共4页U.S.Chinese International Journal of Traumatology

摘　　要：目的:本研究的目的是评价改良“3Z”成形术治疗获得性低位髌骨的疗效。改良的“3Z”成形术将挛缩的髌腱分为内、外、浅、深四部分,进行编织缝合,以实现肌腱组织的多重重叠,加强其强度。方法=2016-2018年,对西安市红会医院收治的6例获得性低位髌骨患者进行了改良“3Z”成形术治疗。以体格检查和标准化评分工具作为评价指标。统计患者术前及术后CD比率、膝关节活动度、Lysholm评分、Tegner活动水平、VAS评分等。记录并发症的发生情况。通过配对f检验对数据进行统计学分析。结果:6例患者的术前平均CD比率为0.54(0.42-0.66),在中位随访24个月(20-28个月)后,校正为1.04(1.01-1.07)。与未受累膝关节144°(140-145°)相比,患者术前中位屈曲从107°(81-134°)提高到142°(114-145°)。所有患者均未出现任何伸展延迟的迹象。患者的Lysholm评分中位数从50分(24-79)提高到90分(69-94),Tegner活动水平从2分(0-6)提高到6分(2-6)。患者的疼痛平均VAS状态从8.4(4-10)降至1(0-2)。6例患者术后均未出现明显的并发症。结论:改良“3Z”成形术是治疗获得性低位髌骨的一种有价值的创新性手术技术。相比于传统的Z形延长术,通过该延长技术缝合后的髌腱强度明显增加。该技术允许患者患肢早期进行功能锻炼,取得了良好的临床效果,值得临床推广。Objective:The purpose of this study is to evaluate the efficacy of modified"3Z"plasty in the treatment of acquired patella baja.The modified"3Z"plasty divides the contracted patellar tendon into four parts:inner,outer,superficial and deep,and then weaves and sutures to achieve multiple overlapping of tendon tissue and strengthen its strength.Methods:From 2016 to 2018,6 patients with acquired patella baja were treated with modified"3Z"plasty in our department.Physical examination and standardized scoring tools were used as evaluation index.Preoperative and postoperative CD ratio,knee range of motion,Lysholm score,Tegner activity level,VAS score,etc.were counted and the occurrence of complications was documented.Finally,the data was statistically analyzed by paired t-test.Results:The mean preoperative CD ratio in 6 patients was 0.54(0.42-0.66),corrected to 1.04(1.01-1.07)after a median follow-up of 24 months(20-28 months).The patient's preoperative median flexion improved from 107°(81°-134°)to 142°(114°-145°)compared with 144°(140°-145°)of the unaffected knee.None of the patients showed any signs of extension delay.The median Lysholm score increased from 50(24-79)to 90(69-94),and the Tegner activity level increased from 2(0-6)to 6(2-6).Patients"mean VAS status for pain decreased from 8.4(4-10)to 1(0-2).No obvious postoperative complications occurred in 6 patients.Conclusion:Modified"3Z"plasty is a valuable and innovative surgical technique for the treatment of acquired patella baja.Compared with the traditional Z-shaped lengthening,the strength of the patellar tendon after suture is significantly increased by this lengthening technique.This technique allows patients to carry out functional exercise of the affected limbs at the early stage,and has achieved a good clinical result,which is worthy of clinical promotion.

关 键 词：获得性低位髌骨 改良 3Z 髌腱 延长 

分 类 号：R68[医药卫生—骨科学]