成人髌骨脱位的手术治疗(附七例报告)

Surgical Treatment of Adult Dislocation of Patella(A Roport of 7 Cases)

目的探讨成人髌骨脱位的病理特点和手术方法。方法对平均手术年龄为36岁的7例9侧髌骨脱位的病例进行回顾性分析。全部病人采用手术治疗,在外侧松解和内侧紧缩的同时,为了增强髌骨内侧的拉力,用股内侧肌头向髌骨外移位缝合以及半腱肌经髌骨移位术。结果本组随访平均2.6年(2～5年),其中8例临床结果良好,无髌骨再脱位情况,无髌股关节炎和疼痛,关节功能近于正常。1例因膝外翻未予矫正而屈膝略受限。结论成人髌骨脱位建议采用手术治疗。在外侧松解和内侧紧缩的同时,结合股内侧肌髌外侧移位术和半腱肌经髌骨移位术的三合一方法,髌股力线恢复确实,术后效果良好。

Objective To investigate the pathological characteristic of adult patellar dislocation and treatment methods.Methods Seven cases of 9 dislocations of patella were analyzed retrospectively.The patients were averaged 35 years.They were treated by lateral soft tissue releasing,medial reefing and reinforced medial stability of vastus medialis,semitendinosus.Results The patients were followed up for averaged 2.6 years (2～5).Eight cases were satisfactory without reoccurrence of dislocation,patellofemoral arthritis and pain.One case was limited by knee joint flexion.Conclusion Its suggested that adult patellar dislocation should be treated by lateral soft tissue releasing,medial reefing and reinforced medial stability of vastus medialis,semitendinosus.