Pathon改良软组织手术治疗先天性髌骨脱位

Pathon modified soft tissue procedure for treatment of congenital patella dislocation

目的 探讨应用Pathon改良软组织手术治疗先天性髌骨脱位的疗效.方法 应用改良Pathon手术治疗先天性髌骨脱位4例.手术采用有限膝前正中皮肤切口,综合组织瓣并髌腱搭扣重叠缝合,广泛内侧组织瓣转移.结果 4例患者进行了为期1.5～2年（平均 20个月）随访,术后无手术并发症,未发生术后再脱位和半脱位.体检及影像学检查示异常步态消失,髌骨轨迹良好,膝外翻和屈曲畸形得到良好改善.结论 Pathon改良法较先前术式手术游离面小,创伤小,操作简单,无需行骨性手术,瘢痕形成少,美观,易为患者接受,是治疗先天性髌骨脱位的一种值得推荐的术式.

Objective To apply the Pathon modified soft tissue procedure for treatment of congenital patella dislocation. Methods Pathon modified soft tissue procedure was performed on 4 cases diagnosed as having congenital patella dislocation. The main features included a limited and straight anterior skin incision, a fashioning of a ＂buckle＂ of the transferred distal - patellar tendon to a distally based flap and the transposition of an extensive medial rotation flap. Results Four cases were followed up for 20 months averagely. No surgical complications, re - dislocation or subluxation occurred. All patients got a good functional recovery with a normal gait, good patella track. Valgus and flexion deformity was corrected. Conclusion The Pathon modified method takes advantages of less dissection and minor invasion over early reported methods. It is easily manipulated with a good cosmetic outlook. It is recommended for future operations on congenital patella dislocation cases.