摘要
目的:比较髌骨内侧韧带紧缩缝合与内侧髌股韧带(Medial Patellofemoral Ligament,MPFL)重建治疗急性髌骨脱位合并髌骨软骨骨折(脱落损伤)的临床疗效。方法:回顾性分析采用髌骨内侧韧带紧缩缝合和内侧髌股韧带重建治疗急性髌骨脱位合并髌骨软骨骨折的40例患者的临床资料。依据术前医患交流及选择,21例采用髌骨内侧韧带紧缩缝合(对照组),19例采用内侧髌股韧带重建(常规组),同时两组髌骨软骨骨折都采用相同缝线经骨固定方式,比较两组相关围手术期指征、随访功能情况。结果:两组患者均完成手术且术中术后均无并发症发生。在近期观察(围手术期)指标方面,对照组手术时间和术中透视次数均显著少于常规组,差异有统计学意义(P<0.05)。而在远期观察(随访功能)指标方面,在随访过程中两组均未再次发生髌骨脱位及髌骨软骨骨折块的脱落及二次骨折。在完全恢复负重活动时间方面,对照组略显优势,差异有统计学意义(P<0.05)。但术后12个月两组组内膝关节Lysholm评分和Kujala评分均显著增加,差异有统计学意义(P<0.05),组内视觉模拟量表(VAS)评分显著减少(P<0.05);但在随访相对应时间点,两组间的统计指标整体差异均无统计学意义(P>0.05)。结论:髌骨内侧韧带紧缩缝合+髌骨软骨骨折复位内固定术与内侧髌股韧带重建+髌骨软骨骨折复位内固定术治疗急性髌骨脱位合并脱落损伤(髌骨软骨骨折)均取得满意临床疗效,但在减少手术时间、术中透视次数及患肢恢复负重活动时间方面,采取髌骨内侧韧带紧缩缝合+髌骨软骨骨折复位内固定术具有明显优势。
Objective:To compare tight patella medial ligament suture and the medial patellofemoral ligament(MPFL)reconstruction on treatment of acute patellar dislocation of patella cartilage fractures(peel off injury)clinical curative efficacy.Methods:40patients with acute patellar dislocation combined with patellar cartilage fracture(peel off injury)treated with medial patellofemoral ligament tightening suture and MPFL reconstruction were analyzed retrospectively.On the basis of preoperative doctor-patient communication and choice,21cases by tightening the medial patellar ligament suture(control group),19patients with the MPFL reconstruction(normal group),at the same time two groups of fracture of patella cartilage is made of the same stitches after bone fixed way.Compared two groups related to perioperative indications,follow-up function.Results:Two groups of patients after surgery and intraoperative no complications occurred.On the recent observation(perioperative)indicators:the control group(tight patella medial ligament suture)in operation time and intraoperative fluoroscopy times were significantly less than the conventional group(MPFL reconstruction)(P<0.05).And observed in the long term follow-up(function)indicators,two groups have been followed up,two groups did not happen again in the process of follow-up patellar dislocation and fracture of patella cartilage block off and secondary fractures.In fully recover time of activity in the control group(tightening the medial patellar ligament suture)slightly advantage(P<0.05).But after one year,knee joint Lysholm scores and Kujala scores of two groups were significantly increased(P<0.05),visual analogue scale(VAS)score significantly reduced(P<0.05),relatively should point at follow-up,statistical indicators of the overall difference between the two groups had no statistical significance(P>0.05).Conclusion:The medial patellar ligament suture with reduction and internal fixation of fracture of patella cartilage and tightening the MPFL reconstruction with patellar cartilage fracture reduction and internal fixation treatment of acute patellar dislocation combined fracture of patella cartilage has achieved satisfactory clinical efficacy,but in the overall time to reduce the operation time,intraoperative fluoroscopy times and limb weight-bearing activities take tight patella medial ligament suture with reduction and internal fixation of fracture of patella cartilage has obvious advantages.
作者
申云杰
朱发良
董思然
段登海
王恩斌
任定宝
杨必超
聂薪洁
SHEN Yunjie;ZHU Faliang;DONG Siran;DUAN Denghai;WANG Enbin;REN Dingbao;YANG Bichao;NIE Xinjie(Baoshan Hospital of Traditional Chinese Medicine(the First Affiliated Hospital of Baoshan College of Traditional Chinese Medicine),Baoshan 678000,Yunnan China;Second People's Hospital of Baoshan,Baoshan 678000,Yunnan China;Dali University,Dali 671000,Yunnan China)
出处
《中国中医骨伤科杂志》
CAS
2024年第2期38-43,共6页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
保山中医药高等专科学校科技计划项目(2024K011)
云南省2023年高层次中医药后备人才培养项目
保山市第十二批科技创新人才项目。
关键词
急性髌骨脱位
髌骨软骨骨折
内侧韧带紧缩缝合
髌骨内侧韧带重建术
acute patellar dislocation
fracture of patella cartilage
medial ligament tight suture
patella medial ligament revascularization
