保留股骨止点的大收肌腱重建内侧髌股韧带治疗解剖异常儿童复发性髌骨脱位  

Reconstruction of medial patellar ligament with adductor magnus tendon preserving femoral insertion for recurrent patellar dislocation in children with anatomical abnormalities

作　　者：王玉琦 王全兵 赵秉浩 阮思源 曹洪 WANG Yuqi;WANG Quanbing;ZHAO Binghao;RUAN Siyuan;CAO Hong(Department of Trauma and Orthopedics,Graduate Joint Training Base,People's Hospital Affiliated to Hubei Medical College,Jinzhou Medical University,Shiyan,Hubei 442000,China;Department of Orthopedics,Shiyan People's Hospital(People's Hospital Affiliated to Hubei University of Medicine),Shiyan,Hubei 442000,China)

机构地区：[1]锦州医科大学湖北医药学院附属人民医院研究生联合培养基地创伤骨科,湖北十堰442000 [2]十堰市人民医院(湖北医药学院附属人民医院)骨关节科,湖北十堰442000

出　　处：《中国医学工程》2022年第12期35-39,共5页China Medical Engineering

基　　金：湖北省卫生健康委2021-2022年度卫生健康科研面上项目(WJ2021M052)。

摘　　要：目的探究使用改良的大收肌肌腱重建内侧髌股韧带的方式治疗存在解剖学异常患儿复发性髌骨脱位的疗效。方法选取于十堰市人民医院门诊及住院治疗的40例髌骨脱位的儿童。结合病史及影像学检查诊断为复发性髌骨脱位。保守组给予手法复位支具外固定,手术组进行手术治疗。统计所有患儿的基本信息,随访2年,统计再次脱位率,末次随访对所有患儿进行Lysholm评分和Kujala评分。结果两组患儿的性别、年龄和部位等一般资料比较,差异无统计学意义(P>0.05)。随访过程中,保守组有11例(55%)患儿复发脱位而手术组患儿仅有2例(10%)复发(P<0.05)。术后手术组的Lysholm评分和Kujala评分明显好于保守组(P<0.05)。结论保留股骨止点的大收肌肌腱重建内侧髌股韧带治疗儿童复发性髌骨脱位可取得满意的疗效,在短期随访中髌骨稳定性良好。后续需进一步观察,明确其远期的稳定效果。【Objective】To explore the efficacy of the modified adductor magnus tendon to reconstruct the medial patellofemoral ligament in the treatment of recurrent patellar dislocation in children with anatomical abnormalities.【Methods】Forty children with patellar dislocation who were treated in outpatient and inpatient departments in Shiyan People's Hospital were selected.Combined with medical history and imaging examination,a diagnosis of recurrent patellar dislocation was made.The conservative group was given manual reduction and brace external fixation,and the operation group was given surgical treatment.The basic information of all children was counted,followed up for 2 years,and the redislocation rate was counted.Lysholm score and Kujala score were performed on all children at the last follow-up.【Results】There was no statistical difference in general data such as gender,age and location between the two groups(P>0.05).During the follow-up,11 cases(55%)of the conservative group had recurrence and dislocation,while only 2 cases(10%)of the surgery group had recurrence(P<0.05).The lysholm score and Kujala score of the postoperative surgery group were significantly better than those of the conservative group(P<0.05).【Conclusion】Reconstruction of the medial patellar ligament with the adductor magnus tendon preserving the femoral insertion can achieve satisfactory results in the treatment of children with recurrent patellar dislocation,and the patella has good stability during short-term follow-up.Further observation is required in the follow-up to clarify its long-term stabilization effect.

关 键 词：儿童髌骨脱位 复发性髌骨脱位 大收肌腱重建 内侧髌股韧带 

分 类 号：R684.8[医药卫生—骨科学]