髌骨周围软组织重建术治疗先天性髌骨脱位  

Reconstructing Soft Tissue around Patella for Treatment of Congenital Dislocation of Patella

作　　者：傅廷友[1] 蓝朝晖[1] 徐培冲[1] 万年宇[1] 

机构地区：[1]山东青岛解放军第401医院骨二科,山东青岛266071

出　　处：《伤残医学杂志》2003年第4期28-29,共2页Medical Journal of Trauma and Disability

摘　　要：目的:探讨髌骨周围软组织重建手术治疗先天性髌骨脱位的方法、疗效。方法:自1987年～2000年共收治先天性髌骨脱位患者6例,年龄8岁～48岁,平均年龄17岁,左侧4例,右侧2例;均采用髌骨周围软组织重建手术治疗:①松解髌骨外侧、紧缩髌骨内侧孪缩组织 ②髌韧带上点内移 ③半腱肌肌腱转移 ④股内侧肌向外侧移位;手术方法的组合:①+②用于年龄较小、脱位较轻者;①+②+③或 ①+②+④或①+②+③+④用于年龄较大、脱位较重者。结果:本组6例术后随访,平均 3年,无术后再脱位现象,有1例膝关节屈曲 90度受限,其余5例伸屈活动正常;年龄最大的1例术后膝关节疼痛较术前减轻,伸膝力较术前增强,但较健侧差。结论:先天性髌骨脱位应尽早诊断早期手术,否则易发生髌股骨关节炎,过早地丧失劳动能力。髌骨周围软组织重建组合手术操作简单,治疗效果好。To analyze the results of reconstructing soft tissues around patella for the treatment of congenital dislocation of patella. Methods: 6 cases with congenital dislocation of patella were treated with reconstructing soft tissues around patella from 1987 to 2000. The age of the patients at the surgery varied from 8 to 48 years. All cases wer unilateral, 4 in left, 2 in right. a, Loosening the outer tissues of the patella and tightening the inner tissues of the patella. b, Meial transfer of patella tendon. c, Transfer of muscle of semitendinosus. d, Outer transfer of muscle of vastus medialis. Operation combination: a and b suits for the younger patients and patients of slight dislocation; a, b and c or a, b and d or a, b, c and d suit for the elder patients and patients of severe dislocation. Results: The average of period of follow-up was 3 years. All of the cases didn't develop patella redislocation after operation. The function of knee in 5 cases were normal without any symptoms and signs. The other 2 cases were abnormal: The oldest one complicated of a alleviative pain of knee after operation. The other was able to bend the knee about 90 degrees. Conclusion: The patients with congenital dislocation of patella must be interfered with operation as early as possible. The disease tended to be arthritis of patella-vastus, and lost the ability to work early. It had a simply operation and a good results to reconstruct soft tissues around patella for the treatment of congenital dislocation of patella.

关 键 词：髌骨周围软组织重建术 手术治疗 先天性髌骨脱位 髌股骨关节炎 手术方法 病理特点 

分 类 号：R684.7[医药卫生—骨科学]