摘要
目的总结应用胫骨结节内移垫高术治疗青少年复发性髌骨脱位的临床疗效及治疗体会。方法2012年3月至2017年8月山东省烟台市烟台山医院小儿骨科收治复发性髌骨脱位患者9例。男4例,女5例;年龄为(17.8±2.9)(14~24)岁;左侧5例,右侧4例。对其中6例无手术治疗史和2例既往外院行关节镜下外侧支持带松解术治疗后再脱位患者行外侧松解、内侧紧缩加胫骨结节内移垫高术;对1例既往外院行内侧髌股韧带重建联合外侧支持带松解术治疗后再脱位患者行外侧松解加胫骨结节内移垫高术。对患者术前与术后膝关节运动范围进行评价;以Lysholm膝关节评分对患者术前与术后膝关节功能进行评价。采用SPSS 17.0软件对数据进行统计学分析。结果随访时间为(16.0±4.0)(12~24)月,未见髌骨再脱位发生。膝关节活动范围术前为(118.5±7.1)°,术后为(131.6±4.3)°,差异有统计学意义(P<0.001);Lysholm膝关节评分术前为(59.4±7.6)分,术后为(89.9±3.5)分,差异有统计学意义(P<0.001)。结论采用胫骨结节内移垫高术治疗青少年复发性髌骨脱位可获得较好的临床疗效。
Objective To investigate the clinical effect and treatment experience of using tibial tubercle inward shifting and heightening surgery for recurrent patellar dislocation in adolescents.Methods Nine patients with recurrent patellar dislocation were treated in the Department of Pediatric Orthopedics,Yantaishan Hospital from March 2012 to August 2017.There were 4 males and 5 females,aged 17.8±2.9.There were 5 cases on the left side and 4 on the right side.Of all the cases,6 patients with no history of surgical treatment and 2 patients with patellar redislocation after undergoing arthroscopic lateral retinaculum release in other hospitals were treated with lateral release,medial tightening and tibial tubercle inward shifting and heightening surgery.One patient with patellar redislocation after medial patellofemoral ligament reconstruction combined with lateral retinaculum release in another hospital was treated with lateral release,tibial tubercle inward shifting and heightening surgery.The range of motion(ROM)of affected knee was evaluated.Lysholm score was used as the preoperative and postoperative evaluation of function of affected knee.Data were statistical analyzed using software of SPSS 17.0.Results The postoperative follow-up duration was(16±?)(12-24)months.No postoperative patellar dislocation was found.The preoperative and postoperative ROM of affected knee were(118.5±7.1)°and(131.6±4.3)°,respectively.The preoperative and postoperative Lysholm score were 59.4±7.6 and 89.9±3.5,respectively.Both defferences were statictically significant(both P<0.001).Conclusion Application of inward shifting of tibial tuberosity in treatment of recurrent patellar dislocation in adolescents could obtain satisfactory clinical effects.
作者
唐伟
仇超
张同庆
马玉鹏
慕明章
杨征
Tang Wei;Qiu Chao;Zhang Tongqing;Ma Yupeng;Mu Mingzhang;Yang Zheng(Department of Pediatric Orthopedics, Yantaishan Hospital, Yantai 264003, China;不详)
出处
《骨科临床与研究杂志》
2021年第4期230-233,共4页
Journal Of Clinical Orthopedics And Research
关键词
髌骨脱位
复发
胫骨
截骨术
青少年
Patellar dislocation
Recurrence
Tibia
Osteotomy
Adolescent
