应用缝匠肌治疗髌骨外侧移位

Use of the sartorius muscle in the treatment of the lateral dislocation of the patella

目的 应用缝匠肌前移治疗因髌韧带外侧紧张、内侧松弛、Q角大于正常所引起的髌软骨软化症、髌骨半脱位及复发性髌骨脱位。方法 游离缝匠肌下1/3段，止点不切断，移至髌骨前固定，建立髌骨向内的可变拉应力，使Q角变小。结果 治疗髌软骨软化症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。结论 本方法设计合理、操作简单，适应髌骨向外侧移位的治疗。

Objective The sartorius muscle was applied to treat tchondromalacia of the patella (CMP), sublaxation of the patella (SLP), recurrent dislocation of patella (RDP) resulted from the patellofemoral ligament lateral tension and medial relaxation with excessive Q angle. Methods The distal one-third part of the sartorius muscle was freed with its insertion intact and transferred to pre-patella to establish dynamic patella ligment and increase the tension force in the medial aspect of patella, so that Q angle was decreased. Results 8 cases (10 knees) with CMP has been treated. 7 cases (8 knees) has been followed-up without pain complaint of the patellofemoral joint. 7 cases (9 knees) with HDP has been treated, 6 cases (7 knees) has been followed-up without the redislocation of the knees. 15 cases(18 knees) with RDP has been treated, 12 cases(13 knees) has been followed-up without the redislocation of patella. Conclusion The method is well designed for easy and simple treatment of dislocation of the patella toward the lateral aspect of the knee.