三联手术治疗成人习惯性髌骨脱位
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1.河南中医药大学第二附属医院;2.河南中医药大学研究生院

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"Triple Surgery" for The Treatment of Habitual Dislocation of Patella
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1.The Second affiliated hospital of henan university of Traditional Chinese Medicine;2.Postgraduate School,Henan University of Traditional Chinese Medicine

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    摘要:

    目的:探讨“三联手术”(膝关节外侧结构彻底松解、内侧髌股韧带重建、胫骨结节內移术)治疗成人习惯性髌骨脱位的疗效。方法:作者自2015年06月—2017年7月应用“三联手术”治疗成人习惯性髌骨脱位患者16例,19膝;年龄17-35岁,平均(25.5±5.4)岁。其中男6例,女10例;左膝4例,右膝9例,双膝3例。本组患者术前膝关节Q角平均(23.54±3.62)°;TT-TG值(22.90±1.90)mm;Insall-Salvati指数(0.7±0.1);Kujala评分(47.85±10.18)分。本组均获随访12-36个月,平均(19.06±6.55)个月。结果:本组内所有患者均未再次出现髌骨脱位,术后膝关节Q角(12.60±3.51)°;TT-TG值(12.46±0.67)mm;Insall-Salvati指数(1.0±0.1);末次随访Kujala评分(85.26±2.26)分,该组患者所有数据与术前相比差异均具有统计学意义(p<0.05)。结论:运用“三联手术”治疗习惯性髌骨脱位能够明显改善患者的膝关节功能,减轻患者痛苦,临床治疗效果满意,是一种治疗成人习惯性髌骨脱位的有效方法。

    Abstract:

    [Purpose] To investigate the efficacy of "triple surgery" (completely loosening the lateral structure of the knee joint, reconstruction of the medial patellofemoral ligament, and internal displacement of tibial nodules ) for the treatment of adult habitual patellofemoral dislocation. [Methods] From June 2015 to July 2017, Author applied “triple surgery” to treat 16 patients with habitual patellofemoral dislocation in adults, 19 knees; aged 17-35 years, mean (25.5±5.4) years old. There were 6 males and 10 females; 4 left knees, 9 right knees and 3 knees. The knee joint Q angle (23.54 ± 3.62) °; TT-TG value (22.90 ± 1.90) mm; Insall-Salvati index (0.7 ± 0.1); Kujala score (47.85 ± 10.18) points. All patients were followed up for 12-36 months, with an average of (19.06±6.55) months.[Result] All patients in this group did not have patellofemoral dislocation again. The knee joint Q angle (12.60±3.51)°; TT-TG value (12.46±0.67) mm; Insall-Salvati index (1.0±0.1); last follow-up Kujala scores were (85.26±2.26). All the data of this group were statistically significant (p<0.05). [Conclusion] The use of "triple surgery" for the treatment of habitual dislocation of patella can significantly improve the knee function of the patient, release the pain of the patient, and the clinical treatment effect is satisfactory.It is an excellent method for treating the habitual dislocation of patella in adults.

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  • 收稿日期:2019-01-10
  • 最后修改日期:2019-05-22
  • 录用日期:2019-05-27
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