习惯性髌骨外脱位的分型改良手术治疗

Classification and Modified Procedure of Habitual Patellar Dislocation

目的：探讨习惯性髌骨外脱位的分型及治疗,改良术式,提高疗效。方法：自2002年7月-2007年7月,对106例118膝习惯性髌骨脱位患者行手术治疗,其中男19例、女87例。年龄8-35岁,平均年龄20.4岁。单侧94例、双侧12例。间发性髌骨外脱位82例,持续性36例。合并髌骨骨软骨骨折11例,合并股骨外髁骨软骨骨折6例,3例同时合并髌骨及股骨外髁骨软骨骨折。结果：本组病例98例110膝得到随访,随访时间4-28个月,平均10.9个月。按Insall标准评价疗效,优73膝、良31膝、可6膝,优良率94.5%。术后无髌骨再脱位和半脱位,无严重并发症发生。结论：只有根据髌骨外脱位的分型,结合屈膝90°位Q角的测量,采用合适的术式矫正脱位和防止脱位复发,才能防止髌股关节软骨进一步损伤,同时将医源性损害降至最低。

Objective：To explore the classification and modified procedure of habitual patellar dislocation and how to improve the therapeutic efficacy.Methods：From July 2002 to July 2007,the modified procedures were performed on 106cases（118knees）of habitual patellar dislocation,which included 19 males and 87 females with anaveraged age of 20.4years old（8-35years old）,94 unilateral dislocation and 12 bilateral dislocation.82 dislocation were accidental and 36 were persistent.11 cases were combined with osteochondral fracture of patella and 6cases were combined with osteochondral fracture of femur condyle.3cases were combined with osteochondral fracture of patella and femur condyle.Results：98cases（110knees）were followed up for average 10.9months（4-28months）.According to the Insall evaluation,73 knees were excellent,31 knees good,6fair.The excellent and good rate was 94.5%.No redislocation and subluxation of patella occurred after operation.No serious complication.Conclusion：According to the classification of the habitual patellar dislocation and the measurement of Q-angle,a suitable procedure can rectify the dislocation and prevent redislocation.And it will prevent the patellofemoral articular cartilage form further damage and decrease the iatrogenic damage to a minimum.