髌骨牵引辅助治疗膝关节僵直

Assistant Treatment on Stiff Knee with Patella Traction

膝关节僵直的主要原因是伸膝装置的粘连与挛缩。作者在股四头肌成形、膝关节松解的基础上，应用髌骨牵引，使挛缩的肌肉在持续张力作用下得以延长。由于股直肌的完整性得以保留，避免了股直肌肌腱延长术可能导致的主动伸膝功能的部分丧失。对于陈旧性股骨干骨折，髌骨牵引不影响内固定的稳定性，使骨折的愈合和膝关节功能康复能同时进行。本组２７例，平均随访１年以上。平均屈膝功能由术前的２８°增至１２１°，平均进步９３°，效果满意。

The main causes of knee stiffness were adherence and contracture of extension device of the knee. After quadricepsplasty was performed, patella traction was applied to extend the contracted muscle by constant tension. Because the integrity of rectus femoris was maintained, the loss of active extenion in part of the knee caused by elongation was avoided. Patella traction did not affected stability of internal fixation for late femoral fracture and nonunion, so the healing of the fracture and functional rehabilitation of the knee could be carried out simultaneously. All of 27 cases were followed up over one year. The average flexion function of the knee joint improved from 28 degrees to 121 degrees, the average gain of flexion was 93 degrees. The result was satisfactory.