摘要
目的探讨腓骨近端切除术后重建膝关节外侧稳定性的方法及效果。方法将2008年1月至2011年12月行腓骨近端切除的36例患者,分为试验组和对照组,试验组共28例,腓骨近端切除后行外侧副韧带和股二头肌腱止点骨性重建;对照组8例,不行韧带重建。两组患者在性别、年龄、肿瘤类型等方面差异无统计学意义（P〉0.05）,具有可比性。术后行膝关节内翻应力试验,X线片测量膝关节外侧间隙,与健侧对比并分级。参照美国骨与软组织肿瘤协会功能评分标准对关节功能进行评分。结果患者均获得随访,随访时间20-52个月,平均35个月。末次随访时,试验组膝关节内翻应力试验均为阴性,关节间隙增大分级为A级;对照组膝关节内翻应力试验均为阳性,关节间隙增大分级为D级。试验组评分为（97.5±3.2）分,对照组为（86.5±3.5）分,两组比较差异有统计学意义（t=2.82,P=0.01）。结论腓骨近端切除后重建外侧副韧带及股二头肌腱止点,操作简单,可恢复膝关节外侧稳定性,利于关节功能恢复。
Objective To investigate the method and the clinical outcomes of reconstruction of lateral stability of the knee after resection of the proximal fibula.Methods From January 2008 to December 2011,there were 36 patients who underwent resection of proximal fibula.These patients were divided into two groups：the experimental group,which including 28 patients who underwent reconstruction of the lateral collateral ligament and the tendon of the biceps with anchors;the control group,which including 8 patients without reconstruction.There was no significant difference in gender,ages,type of tumors between 2groups（P 0.05）.Varus stress test was performed after operation;X-ray films were taken to measure the lateral space of the knee.Musculoskeletal Tumor Society（MSTS） functional score system was used to evaluate the knee joint function.Results All patients were followed up for 20 to 50 months,with an average of 35 months.At last follow-up,the results of varus stress test of the knee were negative in the experimental group and positive in the control group;the lateral space of the joint increased and was classified as grade A in the experimental group and grade D in the control group.The MSTS score was 97.5 ±3.2 in the experimental group and 86.5 ± 3.5 in the control group,showing significant difference（t = 2.82,P = 0.01）.Conclusion The reconstruction of the lateral collateral ligament and the tendon of the biceps femoris with anchors after resection of the proximal fibula is a simple technique to reconstruct lateral stability and promote function of the knee.
出处
《实用骨科杂志》
2014年第11期991-994,共4页
Journal of Practical Orthopaedics
关键词
腓骨近端切除
膝关节稳定性
韧带止点重建
resection of the proximal fibula
knee stability
reconstruction of ligament attachment
