股外侧肌远端筋膜瓣折叠修复重建髌韧带的临床疗效分析

he Clinical Outcome of Anatomical Reconstruction of the Patellar Tendon Using a Y-shaped Flap Folded Back from the Vastus Lateralis Fascia

目的评价股外侧肌远端筋膜瓣折叠修复重建陈旧性髌韧带断裂的安全性及临床疗效。方法对2008年6月-2010年10月收治的10例陈旧性髌韧带断裂患者,采用股外侧肌远端筋膜瓣折叠联合减张钢丝张力带固定方法重建髌韧带。术后1、2、3、6及12个月随访,采用美国膝关节协会评分对膝关节功能进行评分,包括膝关节疼痛、行走能力和上下楼梯能力、活动度等,同时行超声检查对膝关节髌韧带的连续性进行评估。结果 10例患者中9例获得随访,平均随访12个月(6～15个月)。末次随访时平均膝关节疼痛评分、功能评分、膝关节活动范围均较术前明显改善。超声检查显示所有患者肌腱完全愈合,连续性完好,不需要进一步外科手术干预。所有随访患者均未发生手术相关并发症。结论采用股外侧肌远端筋膜瓣折叠重建陈旧性髌韧带断裂是一种有效、可靠的方法,能够恢复良好的膝关节功能。

Objective To evaluate the safety and efficacy of reconstruction of the patellar tendon using a Y-shaped flap folded back from the vastus lateralis fascia.Methods Reconstruction of the patellar tendon using a Y-shaped flap folded back from the vastus lateralis fascia was performed on ten patients with an average age of 37 years（ranged from 16 to 59 years） between June 2008 and October 2010.The Knee Society score was determined and ultrasonography was performed to evaluate the function and stability of knee joint during the 1-,2-,3-,6-and 12-month follow-up.Results At a mean follow-up of 12 months（6-15）,both the physical and ultrasound monitoring showed that all tendons healed properly.At the last follow-up,the mean Knee Society pain and function score improved and the average range of motion of the knee increased significantly after the operations.Conclusion The proposed method of anatomical reconstruction of the patellar tendon using a Y-shaped flap folded back from the vastus lateralis fascia proves to be a valid and good method to reconstruct the rupture of the patellar ligament.