急性髌骨脱位治疗方法的比较

Comparison of methods for the treatment of acute dislocation of patella

目的髌骨脱位是骨科常见疾病，包括急性髌骨脱位和习惯性髌骨脱位，目前在关于急性髌骨脱位的治疗意见方面存在较大分歧，本研究意在对急性髌骨脱位的手术治疗和保守治疗进行简单的比较，总结急性髌骨脱位的主要治疗措施。方法2011年10月-2013年3月，某医院共收治急性髌骨脱位病例8例，其中男3例，女5例，年龄19—40岁，左膝1例，右膝7例，根据患者的治疗意愿，将患者分为手术治疗组和保守治疗组，其中手术治疗组3例，保守治疗组5例，8例患者均有患膝关节痛疼、肿胀及髌骨不稳，髌骨向外侧活动度明显增大，恐惧症阳性，x线检查见髌骨外侧脱位。结果保守治疗组测量Q角为（15±3）。，根据kujala髌股关节评分标准对患者进行评分，总评分为（62．8±9．4）；手术治疗组测量Q角（13±2）。，根据kujala髌股关节评分标准对患者进行评分，总评分为（88．0±3．0）。结论对于急性髌骨脱位，就本次试验而言，进行手术治疗的预后结果要优于保守治疗的预后结果，但仍需要进一步的研究。

Objective The dislocation of patella is a common orthopedic disease, including acute dislocation of patella and habitual dislocation of patella. There is a bigger difference in the medical advice of acute dislocation of patella now. This article compares simply the surgical and conservative treatment of acute dislocation of patella, and summarizes the main treatment measure of acute dislocation of patella. Methods Eight cases with acute dislocation of patella admitted into a hospital from October 2011 to March 2013, of which 3 males and 5 females, the age of patients was 19 to 40 years old, 1 case with the lesion locating in the left knee and 7 cases with the lesion locating the right knee, which were divided into 3 cases in the surgical treatment group and 5 cases in the conservative treatment group according to the patient＇s treatment wishes. All patients suffered from knee pain, swelling and instable patella, the patella＇s activity towards outside increased significantly, the phobia showed positive, the X-ray examination showed lateral dislocation of patella. Results The measured Q angle in the conservative treatment group and the surgical treatment group was （15 ~ 3） , （13 2） respectively, the total score was （62.8 ~ 9.4）, （ 88.0 ~ 3,0） respectively according to the kujala patello-femoral joint score criteria. Conclusion For acute dislocation of patella, the prognosis result of surgical treatment is better than that of conservative treatment in the present experiment, but the further study is still needed.