摘要
目的对比观察手术方法和保守方法治疗急性髌骨脱位的临床效果。方法回顾性分析自2004年6月至2009年10月手术治疗和保守治疗急性髌骨脱位患者的临床资料，其中手术组18例，保守组17例，记录再脱位的病例数，CT测量髌骨外移度及髌骨倾斜角并以Kujala评分进行膝关节功能评估。结果所有患者均随访12个月以上。（1）手术组无再脱位病例，保守组有7例（41．2％）发生再脱位，两组比较差异有统计学意义（χ2=9．265，P=0．002）。（2）术后随访两组患者髌骨倾斜角：手术组均恢复正常（100％），保守组仅8例（47．1％）恢复正常，两组比较差异有统计学意义（χ2=10．980，P=0．001）；髌骨外移：手术组均恢复正常，保守组仅6例（35．3％）恢复正常，两组比较差异有统计学意义（χ2=7．667，P=0．006）。（3）膝关节Kujala评分：手术组术后为（90±5）分，与术前比较[（58±6）分]有显著提高（t=16．465，P〈0．01）；保守组术后为（72±6）分，与术前比较[（62±8）分]提高不明显（t=0．943，P〉0．05），术后组间比较手术组高于保守组，两组比较差异有统计学意义（t=12．256，P〈0．01）。结论临床上对于急性髌骨脱位的治疗，手术方法能明显恢复髌骨稳定性，提高膝关节功能。
Objective To compare the clinical results of surgical and conservative treatment of acute patellar dislocations. Methods Retrospective analyzed the clinical data of 35 patients with acute patellar dislocations from June 2004 to October 2009, and divided the patients into 2 groups. One group with 18 patients underwent surgical treatments, and the other group with 17 patients underwent conservative treatments, record the number of relapses cases of both the two groups. A radiographic examination was performed in the evaluation of the patients,and the Kujala questionnaire was applied with the intention of analyzing the improvement of pain and quality of life. Results All patients were followed up for more than 12 months. （ 1 ） The conservative treatment group exhibited a higher number of recurrent dislocations （7 patients） （41.2%） than the surgical treatment group,which did not have any relapses （ χ2 = 9. 265, P = 0. 002）. （ 2 ） The patellar tilt returned to normal in the surgical group, while 8 patients returned to normal in the conservative group, with statistical difference between groups （χ2 = 10. 980, P = 0. 001 ）. And the lateral shift ratio returned to normal in the surgical group,while 6 patients returned to normal in the conservative group, with statistical difference between groups（ χ2 = 7.667 ,P = 0. 006）. （3）The surgical treatment group obtained a significantly better mean score on the Kujala test than preoperative （ （ 90 ± 5 ） vs. （58 ± 6 ）, t = 16. 465, P 〈 0. 01 ） ; The conservative treatment group, compared with the preoperative,is not improved obviously （ （72 ±6）vs. （62 ±8） ,t =0. 943 ,P 〉0. 05） ;Postoperative group comparison , surgical group was higher than that in conservative group, there was significant difference between two groups （ t = 12. 256, P 〈 0. 01 ）. Conclusion For acute patellar dislocation, surgical treatment can significantly restore patellar stability, improve the function of knee joint.
出处
《中国综合临床》
2013年第8期858-861,共4页
Clinical Medicine of China
关键词
急性髌骨脱位
内侧髌股韧带
解剖重建
保守治疗
Acute patellar dislocation
Medial patello femoral ligament
Anatomy reconstruction
Conservative treatment
