中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (39): 7238-7241.doi: 10.3969/j.issn.1673-8225.2011.39.005

• 数字化骨科 digital orthopedics • 上一篇    下一篇

Q角测量评估膝关节软组织平衡和骨性手术治疗习惯性髌骨脱位的疗效

桂斌捷,刘德宝,卢晓林,周  建   

  1. 安徽医科大学第一附属医院骨科,安徽省合肥市230033
  • 收稿日期:2011-06-30 修回日期:2011-08-01 出版日期:2011-09-24 发布日期:2011-09-24
  • 作者简介:桂斌捷☆,男,1968年生,上海市人,汉族,2004年解放军第二军医大学毕业,博士,副主任医师,主要从事脊椎外科研究。 guibinjie@163.com

Q angle measurement for surgical treatment of patella dislocation based on knee soft tissue balance

Gui Bin-jie, Liu De-bao, Lu Xiao-lin, Zhou Jian   

  1. Department of Orthopedics, First Affiliated Hospital of Anhui Medical University, Hefei  230033, Anhui Province, China
  • Received:2011-06-30 Revised:2011-08-01 Online:2011-09-24 Published:2011-09-24
  • About author:Gui Bin-jie☆, Doctor, Associate chief physician, Department of Orthopedics, First Affiliated Hospital of Anhui Medical University, Hefei 230033, Anhui Province, China

摘要:

背景:手术治疗习惯性髌骨脱位可通过平衡髌骨内外侧软组织,改善Q角,达到纠正髌骨脱位。
目的:探讨Q 角测量评估膝关节软组织平衡和骨性手术治疗习惯性髌骨脱位的疗效。
方法:治疗前常规测量18例习惯性髌骨脱位患者Q角,按Q角分为两组:<16°组,行膝关节外侧关节囊松解、内侧关节囊紧缩;>16°组,行膝关节外侧关节囊松解、内侧关节囊紧缩+髌韧带止点内移或膝关节外侧关节囊松解、内侧关节囊紧缩+髌韧带止点内移和股内外侧肌止点位移。
结果与结论:两组术后Q角明显低于术前,术后膝关节评分明显高于术前(P < 0.001),两组间比较差异无显著性意义(P > 0.05)。Q 角测量评估显示平衡膝关节软组织和骨性手术治疗习惯性髌骨脱位具有疗效明确,并发症少,功能恢复好的优点。

关键词: 髌骨脱位, 手术治疗, Q 角测量, 膝关节, 软组织平衡

Abstract:

BACKGROUND: Surgical treatment of habitual dislocation of the patella can improve the Q angle to correct dislocation of the patella through the lateral patellar soft tissue balance.
OBJECTIVE: To evaluate the clinical effects of surgical treatment of the habitual dislocation of the patella based on knee soft tissue balance by Q angle measurement.
METHODS: Q angles in 18 cases of habitual dislocation of the patella before surgery were measured, according to which, 18 cases were divided into two groups: <16° group, treated by the knee joint capsule lateral release, medial joint capsule tightening; >16° group, treated by the knee joint capsule lateral release, medial joint capsule tightening, tibial tubercle transposition and/or the lateral and medial part of quadriceps displacement.
RESULTS AND CONCLUSION: Postoperative Q angle was significantly improved in the two groups as compared with that before operation as well as the score of Lysholm-Gillquist (P < 0.001). There was no significant difference between the two groups ( > 0.05). Results of Q angle measurement show that based on on knee soft tissue balance, these surgery treatments for of patella dislocation have fewer complications and benefits to the functional recovery of the knee joint.

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