急性滑脱性髌股关节撞击症的治疗观察

Treatment of Acute Patellofemoral Joint Impingent

目的：进一步了解急性滑脱性髌股关节撞击症,探讨其发生机制,诊断及治疗。方法：我院2004-07-2006-03共收治了7例急性膝关节扭伤患者,均为不慎滑倒损伤,膝关节迅速肿胀,疼痛剧烈,不能曲伸。X线片未见异常或者髌骨上下极见少许模糊影,M R I示髌骨内侧面骨软骨骨折行急诊切开减压,骨折复位内固定,术后外固定3周,开始膝关节主动功能锻炼,5-6周CT显示骨折块在位,内固定钢丝在位,股骨髁软骨下骨挫伤。结果：均获随访12-28个月,平均20个月,未出现髌股关节疼痛,髌骨内侧面骨软骨骨折块无脱落。结论：急性滑脱性髌股关节撞击症患者,应早期诊断,急诊手术治疗,术后1周行主动股四头肌收缩训练,术后3周去除外固定主动膝关节功能锻炼,可收良好的疗效。

Objective：To explore the mechanism,definition and treatment of acute patellofemoral joint impingent. Methods：From July 2004 to March 2006,7 patients aging from 18 to 35 years with 4 males and 3 females （2 left knees, 5 right knees） were diagnosed as acute patellofemoral joint impingent and treated with surgical treatment. Knee joint swamp,painful and unable to exercise occurred in all cases injured due to slippery. X-ray film showed normal or a little intensity abnormal ,MRI findings revealed patella sublexation,joint effusion, fracture of cartilage and bone in the inferior medial part and medial retinaculum injuries of patella. Reducing joint pressure and fracture site fixing by acute operation, fixing by plaster for 4-5 weeks following operation,knee joint exercising following operation. Result ：All patients were followed up with twenty months. According to insall evaluation,5 cases showed excellent result, two good. Conclusion： The patients of acute patellofemoral joint impingent will be early diagnosed and treated with surgical treatment. Acute surgical treatment,active exercise of quadriceps one week after surgery and active function exercise when the plaster Is removed four to five weeks after surgery are effective for the treatment of acute patellofemoral joint impingent.