关节镜辅助下治疗习惯性髌骨脱位合并髌骨骨软骨骨折的疗效

The Effect of Arthroscopic Adjuvant Treatment for Chronic Patellar Dislocation combined with Patellar Osteochondral Fracture

目的探讨关节镜辅助下应用可Ethicord线、联合髌外侧支持带松解+内侧支持带紧缩缝合、股薄肌、半腱肌移植治疗习惯性髌骨脱位合并髌骨软骨骨折的效果。方法选取11例习惯性髌骨脱位合并髌骨骨软骨折患者作为研究对象,本组患者均先行膝关节镜下探查,髌骨骨软骨骨折切开复位Ethicord线内固定+内侧支持带紧缩缝合+外侧支持带松解手术治疗。术后膝关节可调节支具固定3周后开始膝关节伸屈功能锻炼,术后3个月、6个月复查X线及MRI(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。结果术后6个月,11例患者骨折全部愈合,术后无髌骨再脱位,采用国际膝关节评分委员会HSS评分及Lysholm评分。结论采用膝关节镜下探查,髌骨骨软骨骨折切开复位Ethicord线内固定+内侧支持带紧缩、重建+髌外侧支持带松解手术治疗髌骨脱位合并骨软骨骨折效果满意,适合临床推广。

Objective To explore the application under arthroscopy assisted Ethicord line, joint lateral patellar retinaculum release with＋inside suture, gracilis muscle, tendon and muscle transplantation for the treatment of habitual patellar dislocation of patella cartilage fractures. Methods 11 patients with fracture of habitual patellar dislocation combined patella bone soft as the research object, this group of patients were frst probe, under the arthroscopic osteochondral fracture of patella Ethicord wire internal fxation （orif＋medial retinaculum tight suture＋lateral retinaculum release surgery. Postoperative knee can be adjusted with a fxed began to fex the knee joint function exercise after 3 weeks, 3 months, 6 months after review of X-ray and MRI or CT, observe the healing of patella cartilage, patella cartilage after healing begin weight-bearing activities. Results After 6 months of operation, all of the 11 patients were healed without patellar dislocation, and the HSS score and Lysholm score of the international knee scoring committee were adopted. Conclusion Using the arthroscopic probe, under the osteochondral fracture of patella Ethicord wire internal fxation （orif＋medial support belt tightening, reconstruction, lateral patellar retinaculum release osteochondral fractures after surgical treatment patellar dislocation effect is satisfed, suitable for clinical promotion.