带线锚钉联合髌骨横向钻孔修复股四头肌腱骨腱结合部断裂

Repair of the fracture of the joint of tendon and bone of the quadriceps femoris tendon with wire anchor and transverse drilling of the patella

目的:探索带线锚钉联合髌骨横向钻孔修复股四头肌腱骨腱结合部断裂的效果。方法:自2016年4月至2018年1月采用带线锚钉结合髌骨横向钻孔修复治疗6例(8膝)股四头肌腱骨腱结合部位完全断裂患者,其中男5例(7膝),女1例,年龄43~74岁,平均53岁。患者外伤后均出现膝关节疼痛和无法主动伸膝,膝关节均行X线、CT、MRI检查,明确其均为股四头肌腱骨腱结合部完全断裂。手术后定时复查膝关节X线,并在术后使用Lysholm评分评价膝关节功能。结果:所有患者单侧手术时间平均60 min,术中使用止血带,术后不放置引流,所有患者未输血。6例患者术后获随访,时间15~36个月,平均26个月。6例患者(8膝)术后末次随访Lysholm评分79~95分,平均89分。其中1例强制性脊柱炎患者发生感染,经过2次清创手术后愈合。结论:带线锚钉结合髌骨横向钻孔修复股四头肌腱骨腱结合部断裂缝合结构简易牢靠且效果显著。

Objective:To explore the effect of suture anchor combined with transverse drilling of patella to repair the fracture of the joint of bone and tendon of quadriceps femoris tendon.Methods:From April 2016 to January 2018,6 patients(8 knees)with complete rupture of the joint of the tendon and bone tendon of the quadriceps femoris were treated with the combination of anchor with wire and transverse drilling of the patella,including 5 males(7 knees)and 1 female,aged from 43 to 74 years with an average age of 53 years old.All the patients had pain in knee joint and could not extend the knee actively after trauma.X-ray,CT and MRI were performed on the knee joints,and it was clear that the joint of bone and tendon of quadriceps femoris tendon was completely broken.The X-ray of knee joint was reviewed regularly after operation,and Lysholm score was used to evaluate the function of knee joint.Results:The average operation time of all patients was 60 minutes.Tourniquets were used during the operation,no drainage was placed after the operation,and no blood transfusion was performed in all patients.Six patients were followed up for 15 to 36 months with an average of 26 months.Lysholm score of 6 patients(8 knees)was 79 to 95 in the last follow-up with an average of 89 points.One of the patients with mandatory spondylitis developed infection and healed after 2 debridements.Conclusion:The suture structure of the joint of bone and tendon of quadriceps femoris tendon repaired with suture anchor and lateral drilling of patella is simple,reliable and effective.