文章摘要
昌震,郑江,张明宇,等.复位固定联合韧带修复治疗伴内侧髌股韧带及骨软骨损伤的创伤性髌骨脱位.骨科,2018,9(3): 188-192.
复位固定联合韧带修复治疗伴内侧髌股韧带及骨软骨损伤的创伤性髌骨脱位
Clinical efficacy of reduction fixation with ligament repair for treatment of the traumatic patellar dislocation with knee joint osteochondral fractures and medial patellofemoral ligament injury
投稿时间:2018-02-05  
DOI:10.3969/j.issn.1674-8573.2018.03.005
中文关键词: 髌骨脱位  骨软骨骨折  内侧髌股韧带  可吸收棒  关节镜检查
英文关键词: Patellar dislocation  Osteochondral fracture  Medial patellofemoral ligament  Absorbable rods  Arthroscopy
基金项目:陕西省科技厅项目(2015JM8482)
作者单位E-mail
昌震 710054 西安西安交通大学医学院附属红会医院运动医学中心  
郑江 710054 西安西安交通大学医学院附属红会医院运动医学中心  
张明宇 710054 西安西安交通大学医学院附属红会医院运动医学中心  
康鑫 710054 西安西安交通大学医学院附属红会医院运动医学中心  
张宪 710054 西安西安交通大学医学院附属红会医院运动医学中心  
张亮 710054 西安西安交通大学医学院附属红会医院运动医学中心 glowthy@sina.com.cn 
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中文摘要:
      目的 分析采用可吸收棒复位固定膝关节骨软骨骨折联合内侧髌股韧带(medial patellofemoral ligament, MPFL)修复治疗伴有MPFL及骨软骨损伤的创伤性髌骨脱位的临床效果。方法 对2013年1月至2017年1月我院收治81例伴有MPFL及膝关节骨软骨损伤的创伤性髌骨脱位病人进行回顾性分析,其中男29例,女52例;年龄为16~33岁(平均17.7岁)。采用膝关节骨软骨骨折固定联合MPFL修复治疗的65例纳入固定修复组,采用膝关节骨软骨骨折清理联合MPFL修复治疗的16例纳入清理修复组。收集两组病人术后的膝关节功能障碍、再脱位的发生率及膝关节疼痛情况等,并比较两组病人术前及术后1年的国际膝关节文献委员会(the international knee documentation committee, IKDC)膝关节评分和Lysholm评分。结果 81例病人平均随访28.6个月。固定修复组出现2例(2/65,3.08%)术后膝关节功能障碍,3例(3/65,4.62%)再脱位;清理修复组有1例(1/16,6.25%)再脱位,4例(4/16,25.00%)膝前疼痛。固定修复组的IKDC评分由术前的(43.1±13.2)分提高到术后的(83.8±6.3)分,Lysholm评分由术前的(48.3±6.2)分提高到术后的(87.1±9.8)分;清理修复组的IKDC得分由术前的(42.3±9.8)分提高到术后的(80.2±3.2)分,Lysholm评分由术前的(49.5±5.4)分提高到术后的(81.3±5.4)分。两组手术前后的IKDC、Lysholm评分差异均有统计学意义(P均<0.05),但两组间的IKDC、Lysholm评分差异均无统计学意义(P均>0.05)。结论 可吸收棒复位固定骨软骨骨折联合MPFL修复是治疗伴有MPFL及膝关节骨软骨损伤的创伤性髌骨脱位的有效方法。
英文摘要:
      Objective To discuss the clinical efficacy of the absorbable rods and MPFL repair techniques for the traumatic patellar dislocation patients with knee joint osteochondral fractures and medial patellofemoral ligament (MPFL) injury. Methods All of 81 traumatic patellar dislocation patients with knee joint osteochondral fractures and MPFL injury were analyzed retrospectively from January 2013 to January 2017, including 29 males and 52 females, aged 16 to 33 years old, average 17.7 years. Sixty-five cases accepted fixation of the knee joint osteochondral fractures in combination with repair of MPFL injury (fixation-repair group), 16 patients underwent cleaning of knee joint osteochondral fracture combined with repair of MPFL injury (cleaning-repair group). The data on the postoperative knee dysfunction, the incidence of re-dislocation and knee pain were collected. The international knee documentation committee (IKDC) and Lysholm knee joint function scores were compared. Results All of 81 patients were followed up for 28.6 months. There were 2 cases (2/65, 3.08%) of postoperative knee dysfunction, and 3 cases (3/65, 4.62%) of re-dislocation in the fixation-repair group, and 1 case (1/16, 6.25%) of re-dislocation and 4 (4/16, 25.00%) cases of anterior knee pain in the cleaning-repair group. The average IKDC score in the fixation-repair group was increased from 43.1±13.2 to 83.8±6.3, and the Lysholm score was increased from 48.3±6.2 to 87.1±9.8. The IKDC score in the cleaning-repair group was increased from 42.3±9.8 to 80.2±3.2, and the Lysholm score was increased from 49.5±5.4 to 81.3±5.4. All differences were statistically significant before and after operation in the two groups (P<0.05), but there was no statistically significant difference between the two groups (P>0.05 for all). Conclusion The fixation of the joint osteochondral fractures with absorbable rods combined with MPFL repair is an effective method to treat the traumatic patellar dislocation patients with knee joint osteochondral fractures and MPFL injury.
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