髌骨骨折支持带的修复与髌骨轨迹变化之间关联性的实验研究

An Experimental Study of Repair Patella Support Band and Patellar Track Changes Associated in Patellar Fractures

目的:探讨髌骨骨折并内外侧支持带损伤,在内固定髌骨骨折同时修复支持带的必要性。方法:通过人体尸体新鲜膝关节标本上制备髌骨骨折及支持带损伤模型,根据内固定术中是否还修复支持带,分为A组(骨折无并支持带损伤组)10例、B组(支持带不修复组)20例、C组(支持带修复组)20例;分别通过30°、60°、90°髌骨轴位片对比各组髌骨轨迹的变化,并测量髌股合适角判断有无髌骨不稳定。结果:髌骨骨折并支持带损伤不修复支持带组,出现不同程度的髌骨不稳定,髌股合适角>0°或<-12°;修复支持带后髌股合适角恢复正常。结论:对于髌骨骨折并内外侧支持带损伤,治疗骨折的同时应该修复支持带,有利于髌骨稳定性的恢复。

Objective：To discuss the necessity of repair of retinaculum as well as patellar fracture in case of patellar fracture with rupture of medial and lateral patellar retinaculurm Methods：The models of patellar fractures with rupture of medial and lateral patellar retinaculum are produced with human cadaveric knee specimens, and are divided into： 10 knees in group A （patellar fractures without rupture of medial and lateral patellar retinaeulum）, 20 knees in group B （patellar fractures with rupture of medial and lateral patellar retinaculum but without repair of retinaculum）, 20 knees in group C（patellar fractures with rupture of medial and lateral patellar retinaculum and with repair of retinaculum） compare the difference of patellar traiectory in the three groups by the means of 30°, 60°, 90° patellar axial view, and de- termine patellar instability through measurement of patello-femoral congruence angle. Results： In group A, there are pa-tellar instabilities in different extents; the patello-femoral congruence angles are out of the range of 0° --12°. the pa-tello-femoral congruence angles in group C are normal（between 0°--12°）. Conclusion： For patellar fracture with rup-ture of medial and lateral patellar retinaculum, we should repair of retinaculum as well as patellar fracture for the aim of restore the patellar stability.