关节镜辅助下治疗青少年习惯性髌骨脱位合并髌骨软骨骨折的效果

Effect of arthroscopic assisted treatment of adolescents habitual patellar dislocation complicated with patellar cartilage fracture

目的探讨关节镜辅助下应用可吸收棒、联合髌外侧支持带松解+内侧支持带紧缩缝合治疗青少年习惯性髌骨脱位合并髌骨软骨骨折的效果。方法选取2008年2月~2014年5月我科收治的7例青少年习惯性髌骨脱位合并髌骨软骨骨折患者作为研究对象,所有患者均行膝关节镜下探查、髌外侧支持带松解+髌骨软骨骨折切开复位可吸收棒内固定+内侧支持带紧缩缝合手术治疗。术后石膏固定3周后开始膝关节伸屈功能锻炼,术后3个月复查X线或CT,观察髌骨软骨愈合情况,髌骨软骨愈合后开始负重活动,采用HSS评分评价膝关节功能并评价髌骨再脱位情况。结果术后6个月,7例患者骨折全部愈合,HSS评分显示,优6例,良1例。术后无髌骨再脱位。结论对于青少年习惯性髌骨脱位合并髌骨软骨骨折,采用膝关节镜下探查、髌外侧支持带松解+髌骨软骨骨折切开复位可吸收棒内固定+内侧支持带紧缩缝合手术治疗效果满意。

Objective To explore the effect of arthroscopic assisted treatment of adolescents habitual patellar dislocation complicated with patellar cartilage fracture by using the methods of absorbable screw,combined lateral patella retinaculum release and medial retinaculum tightening suture.Methods A total of 7 young patients with habitual patellar dislocation complicated with patellar cartilage fracture from February 2008 to May 2014 were selected as the research objects.All patients were treated with surgical treatment,included arthroscopic exploration,release of lateral patella retinaculum,reduction and internal fixation for patella cartilage with absorbable screw,medial patellar retinaculum reefing.Plaster immobilization were needed for 3 weeks Postoperative.All patients were began functional training.3 months after operation,weight-bearing activities were began if the X-ray or CT showed patella cartilage healing.HSS score was used to evaluate knee function and evaluate patellar dislocation.Results All 7 patients achieved fracture healing without patellar dislocation after operation for 6 months.According to HSS evaluation,6 cases were excellent,one case was good.Conclusion The effect of the combined operation method of arthroscopic exploration,release of lateral patella retinaculum,reduction and internal fixation for patella cartilage with absorbable screw,medial patellar retinaculum reefing in the treatment of adolescents habitual patellar dislocation complicated with patellar cartilage fracture is satisfactory.