缝线锚钉结合改良Kessler缝合法修复股四头肌腱髌骨止点断裂

Combined suture anchor with improved Kessler technique in repair of quadriceps tendon rupture

目的评估缝线锚钉结合改良Kessler缝合法修复股四头肌腱髌骨止点断裂的临床疗效。方法 2014年5月至2016年6月期间,临沂市人民医院对收治的21例单侧股四头肌腱髌骨止点断裂患者,采用缝线锚钉结合改良Kessler缝合法行股四头肌腱髌骨止点修补缝合术。其中男17例,女4例;年龄16~68岁,平均33.3岁;左侧15例,右侧6例;运动损伤13例,碰撞损伤8例。受伤至手术时间为3 h^7d,平均2.1 d。术前常规拍摄患侧膝关节X线片及MRI,术后6周内支具保护,6周后行屈膝练习,术后6个月测量患者屈膝角度,并采用Lysholm评分系统评估患者功能恢复情况。结果本组21例患者均获得随访。21例患者均未发生锚钉松动及脱出。术后6个月屈膝角度差异无统计学意义(P>0.05)。术后6个月Lysholm评分术后得分较术前得分差异有统计学意义(P<0.05),两组患者术后得分差异无统计学意义(P>0.05)。结论应用缝线锚钉结合改良Kessler缝合法行股四头肌腱髌骨止点修复具有确切的临床疗效。

Objective The purpose of this study is to report results of combined suture anchor with improved Kessler technique in repair of quadriceps tendon rupture. Methods From May 2014 to June 2016, 21 patients with quadriceps tendon rupture were treated by combined suture anchor with improved Kessler technique. Of 21 cases, 17 were male and 4 were female, aged 16~68 years （mean, 33.3 years）. The left side was involved in 15 cases and the right sidein 6 cases. The causes of injury included sport injury in 13 cases and collision damage in 9 cases. The time from injury to operation was 3 hours to 7 days （mean, 2.1days）. Protection was advised within 6 weeks, and knee flexion exercise was initiated 6 weeks later. The angle of knee flexion was measured 6 months after operation and the efficacy evaluation had also been performed using Lysholm scores at the same time. Results All patients were followed up thoroughly, which found no loosening of prolapse in any of the patients. There were no statistically significant differences in the angle of knee flexion between two groups （P〉0.05）. There were statistically significant differences in the pretherapy group and post-treatment groups （P〈0.05） and there were no statistically significant differences in Lysholm scores between two groups after operation （P〉0.05）. Conclusion Suture anchor repair of quadriceps tendon rupture in the end point is an effective way.