贴面固定与隧道固定重建内侧髌股韧带治疗青少年复发性髌骨脱位的早期疗效比较  

Comparison of lateral veneer fixation versus tunnel fixation for reconstruction of the medial patellofemoral ligament in the treatment of recurrent patellar dislocation in adolescents

作　　者：凯沙尔·百合提亚尔 韩然 于飞飞 那次克道尔吉 舒莉[1] Kai Shaer Baihetiyaer;Han Ran;Yu Feifei;Na Cikedaoerji;Shu Li(Department of Pediatric Orthopedics,The Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830063,China)

机构地区：[1]新疆医科大学第六附属医院小儿骨科,乌鲁木齐830063

出　　处：《中华创伤骨科杂志》2024年第5期391-397,共7页Chinese Journal of Orthopaedic Trauma

基　　金：新疆维吾尔自治区自然科学基金面上项目(2021D01C453)。

摘　　要：目的比较髌骨侧贴面固定与隧道固定重建内侧髌股韧带(MPFL)治疗青少年复发性髌骨脱位的早期疗效。方法回顾性分析2020年1月至2023年1月新疆医科大学第六附属医院小儿骨科收治的50例复发性髌骨脱位患者资料。男12例,女38例;年龄(15.0±0.9)岁;左侧23例,右侧27例;术前脱位次数为(2.5±0.9)次。根据手术方式不同将患者分为2组:贴面组(行髌骨侧贴面固定重建MPFL)25例;隧道组(行髌骨侧隧道固定重建MPFL)25例。比较末次随访时两组患者的Kujala评分、Lysholm评分、外侧髌股角(LPFA)、髌股适合角(CA)、髌骨倾斜角(PTA)、髌骨外移度(LPT)。结果贴面组和隧道组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。50例患者术后获(24.1±5.1)个月随访。术后贴面组和隧道组患者均未出现髌骨骨折、关节屈伸功能受限等并发症;末次随访时两组患者均未出现再次髌骨脱位。末次随访时贴面组患者Kujala评分、Lysholm评分、LPFA、CA、PTA、LPT分别为(87.8±4.3)分、(88.3±4.7)分、9.5°±1.1°、10.8°±1.4°、9.6°±1.0°、(9.2±1.3)mm,以上项目隧道组患者分别为(86.0±4.4)分、(87.7±4.2)分、9.5°±1.1°、11.0°±1.6°、9.0°±1.8°、(9.2±1.3)mm。以上项目两组间比较差异均无统计学意义(P>0.05),但以上项目同一组内末次随访时均较术前显著改善,差异均有统计学意义(P<0.05)。结论髌骨侧贴面固定与隧道固定重建MPFL治疗青少年复发性髌骨脱位,均能改善青少年髌股关节对位关系,有助于膝关节功能的改善及髌骨稳定性的提高。Objective To compare the lateral veneer fixation versus the tunnel fixation for reconstruction of the medial patellofemoral ligament(MPFL)in the treatment of recurrent patellar dislocation in adolescents.Methods A retrospective study was conducted to analyze the data of 50 adolescent patients with recurrent patellar dislocation who had been treated at Department of Pediatric Orthopedics,The Sixth Affiliated Hospital of Xinjiang Medical University from January 2020 to January 2023.There were 12 males and 38 females with an age of(15.0±0.9)years,and 23 cases on the left and 27 cases on the right.The number of preoperative dislocations was(2.5±0.9)times.According to the surgical methods,the patients were divided into 2 groups:a veneer group of 25 cases whose MPFL was reconstructed by the patellar lateral veneer fixation,and a tunnel group of 25 cases whose MPFL was reconstructed by the patellar tunnel fixation.The 2 groups were compared in terms of Kujala score,Lysholm score,lateral patellofemoral angle(LPFA),congruence angle(CA),patellar tilt angle(PTA),and lateral patellar displacement(LPT)at the last follow-up.Results As the differences in the preoperative general data between the groups were insignificant,the 2 groups were comparable(P>0.05).The 50 patients were followed up for(24.1±5.1)months after surgery.There were no complications like patellar fracture or limitation of joint flexion-extension in either group after surgery,and neither group experienced any further patellar dislocation at the last follow-up.The Kujala score,Lysholm score,LPFA,CA,PTA and LPT at the last follow-up were(87.8±4.3)points,(88.3±4.7)points,9.5°±1.1°,10.8°±1.4°,9.6°±1.0°,and 9.2±1.3 mm in the veneer group,and(86.0±4.4)points,(87.7±4.2)points,9.5°±1.1°,11.0°±1.6°,9.0°±1.8°,and(9.2±1.3)mm in the tunnel group,respectively,showing no statistically significant difference between the 2 groups(P>0.05).However,there were significant improvements within each group in the comparisons of the above indexes between pre-

关 键 词：膝关节 髌骨脱位 髌韧带 青少年 

分 类 号：R726.8[医药卫生—儿科]