[1]姚俊娜,权松涛,冯伟,等.双束半腱肌肌腱解剖重建内侧髌股韧带 治疗复发性髌骨脱位[J].中医正骨,2018,30(08):54-57.
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双束半腱肌肌腱解剖重建内侧髌股韧带 治疗复发性髌骨脱位()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期数:
2018年08期
页码:
54-57
栏目:
临床报道
出版日期:
2018-08-20

文章信息/Info

作者:
姚俊娜; 权松涛; 冯伟; 蔡利涛; 杨明路
河南省洛阳正骨医院/河南省骨科医院,河南 洛阳 471002
关键词:
髌骨脱位;  修复外科手术;  关节镜检查;  内侧髌股韧带
摘要:
探讨双束半腱肌肌腱解剖重建内侧髌股韧带治疗复发性髌骨脱位的临床疗效和安全性。方法:2014年12月至2017年3月,采用双束半腱肌肌腱解剖重建内侧髌股韧带治疗复发性髌骨脱位患者26例,男9例、女17例; 年龄16～38岁,中位数19岁; 左侧10例,右侧16例。最后一次髌骨脱位至手术时间36 h至21 d,中位数7 d。对胫骨结节—股骨滑车沟间距≥20 mm及Caton指数≥1.2的髌骨高位患者,同期行胫骨结节移位术。观察髌股关节复位情况,分别在术前和术后6个月依据Lysholm和Kujala膝关节评分标准评价患膝功能,随访观察并发症发生及髌骨脱位复发情况。结果:本组26例,行双束半腱肌肌腱解剖重建内侧髌股韧带18例、行双束半腱肌肌腱解剖重建内侧髌股韧带联合胫骨结节移位8例,术后髌骨轴位X线片和CT片均示髌股关节解剖关系恢复正常。26例患者均获随访,随访时间12～24个月,中位数18个月。Lysholm评分,术前(65.6±7.6)分,术后6个月(90.6±4.2)分; Kujala评分,术前(52.5±5.2)分,术后6个月(78.9±8.9)分。术后切口拆线后开裂1例,再次扩创缝合后切口愈合; 并发切口脂肪液化1例,经清创处理后切口愈合; 并发膝关节屈曲受限1例,术后6周全身麻醉下行手法松解,关节功能改善; 并发髌前外侧疼痛1例,加强股四头肌功能锻炼后,症状缓解。均无髌骨脱位复发。结论:双束半腱肌肌腱解剖重建内侧髌股韧带治疗复发性髌骨脱位,可恢复正常髌股关节关系,有利于维持膝关节的稳定、改善膝关节功能,且安全可靠。但对于胫骨结节—股骨滑车沟间距较大、Caton指数较高的患者,须联合胫骨结节移位术。

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中医正骨2018年8月第30卷第8期 J Trad Chin Orthop Trauma,2018,Vol.30,No.8(总617)
(总618)中医正骨2018年8月第30卷第8期 J Trad Chin Orthop Trauma,2018,Vol.30,No.8
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备注/Memo

备注/Memo:
基金项目:河南省中医药科学研究专项课题(2017ZY2125)
更新日期/Last Update: 2018-08-31