应用缝匠肌治疗伸膝功能障碍

Application of sartorius muscle for treatment of extensor dysfunction of the knee

目的 应用缝匠肌前移治疗髌骨向外移位和加强伸膝力量。方法 游离缝匠肌下 1/ 3段、下 2 / 3段 ,其止点不切断 ,移至髌骨前固定。结果 治疗髌骨软化症 8例 10膝 ,随访 7例 8膝 ,髌股关节痛消失 ;髌骨半脱位 7例 9膝 ,随访 6例 7膝 ,髌骨无再半脱位 ;复发性髌骨脱位 15例 18膝 ,随访 12例 13膝 ,髌骨无再脱位 ;股四头肌瘫痪 5 3例 ,随访 34例 ,伸膝平均肌力由术前 0 89级 ,增至2 76级 ;膝关节伸直型僵硬 12例 ,随访 9例 ,膝关节平均活动度由术前 15°增至 10 2° ,伸膝平均肌力由术前Ⅱ级 ,增至Ⅳ级 ;髌骨切除 10例 ,随访 7例 ,伸膝肌力平均增加Ⅱ级 ,能很好完成最后 10°～ 15°的伸膝。结论 利用缝匠肌治疗髌骨向外移位、伸膝肌力减弱 ,方法简单 ,效果确切。

Objective To treat lateral shift of the patella and reinforce the extensor muscle of the knee by front transpostition of the sartorius muscle. Methods The lower 1/3 or 2/3 part of the sartorius muscle was freed with its insertion intact and transposed to the front of the patellar. Results 8 cases(10 knees) of patellar chondromalacia were treated, 7 cases(8 knees)were followed up. Pain in the patellofemoral joint disappeared. 7 cases ( 9 knees) with subluxation of the patellar were treated, 6 cases ( 7 knees) were followed up. No recurrence of patellar subluxation was observed. 15 cases (18 knees) with recurrent patellar dislocation were treated, 12 cases (13 knees ) were followed up. No dislocation of patellar reappeared. 53 cases of paralysis of the quadriceps muscle were treated, 34 cases were followed up. The average myodynamia was increased from 0 89 preoperatively to 2 76. 12 cases of knee stiffness in extension were treated, 9 cases were followed up. The average movement was added to 102° from 15°preoperatively. The average myodynamia was elevated to grade Ⅳ from grade Ⅱ preoperatively. 10 cases of petallectomy were treated, 7 cases were followed up.The extensor muscle power was increased by two grades and the last 10～15 degrees lost in extension recovered. Conclusion Front transpostition of the sartorius muscle is both simple and effective in treating latereal shift of patellar and weakness of extensor muscle.