本文關鍵詞： 膝關節(jié) 青少年復發(fā)性髕骨脫位 脛骨結節(jié)-股骨滑車距離 髕韌帶1/3轉移術　出處：《延邊大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:探索青少年復發(fā)性髕骨脫位患者脛骨結節(jié)-股骨滑車距離的影像學的臨床意義。方法:取自2012年01月至2014年12月本院骨一科收治復發(fā)性髕骨脫位患者共104例,全部患者利用X線檢測髕骨高度和股骨滑車溝角,CT檢測脛骨結節(jié)-股骨滑車距離、髕骨傾斜角。收集統(tǒng)計患者入院時的股骨滑車-脛骨結節(jié)距離數(shù)值并分析。對于臨床資料研究根據(jù)年齡分為低年齡組(8-12歲,A組,N=51)和高年齡組(13-16歲,B組,N=53)。分析術前及術后3個月、6個月、9個月、12個月、24個月的髕骨高度、股骨滑車角、髕骨傾斜角和膝關節(jié)Lysholm評分及髕骨Kujala評分,兩組患者術后并發(fā)癥及術后功能恢復情況。全部患者隨訪24個月,在術后9個月采用膝關節(jié)Lysholm評分、髕骨Kujala評分進行優(yōu)良率評定。結果:在8-16歲復發(fā)性髕骨脫位患者中高年齡組患者的TT-TG數(shù)值(25.27±1.75mm)大于低年齡組患者(17.46±1.14mm);兩組患者性別、手術部位、體質指數(shù)、髕骨高度、髕骨傾斜角、股骨滑車角、膝關節(jié)Lysholm評分、髕骨Kujala評分等術前資料比較無統(tǒng)計學差異(均P0.05)。術后3個月A、B兩組髕骨高度及髕骨傾斜角均較術前減小,術后24個月A組髕骨高度(1.06±0.15)及髕骨傾斜角(18.82±2.15°)均小于B組的髕骨高度(1.28±0.20)及髕骨傾斜角(21.26±2.18°),均有統(tǒng)計學差異(均P0.05)。膝關節(jié)Lysholm評分及髕骨Kujala評分在術后6個月,9個月A組的評分高于B組評分。使用術后12個月膝關節(jié)Lysholm評分進行優(yōu)良率評定,A組優(yōu)良率高于B組。A組術后出現(xiàn)并發(fā)癥患者人數(shù)少于B組,以上差異均具有統(tǒng)計學意義(P0.05)。結論:在青少年復發(fā)性髕骨脫位患者中,高年齡組患者TT-TG數(shù)值較低年齡組患者更大。使用髕韌帶1/3轉移術治療青少年RPD患者在術后24個月內手術效果良好。
[Abstract]:Objective: to explore the clinical significance of the distance between tibial nodule and trochlear in juvenile patients with recurrent patellar dislocation. Methods: from January 2012 to December 2014, 104 patients with recurrent patellar dislocation were treated in our department of bone. The height of patella and the distance between tibial tubercle and femoral trochlea were detected by X-ray and femoral trochlear angle CT. Patellar obliquity angle. The distance between trochlear and tibial nodule was collected and analyzed. The clinical data were divided into low age group (8-12 years old) and high age group (13-16 years old group B) according to age. And the patella height of 3 months, 6 months, 9 months, 12 months and 24 months after operation, Femoral trochlear angle, patellar obliquity angle, knee joint Lysholm score and patellar Kujala score, postoperative complications and functional recovery of the two groups. All patients were followed up for 24 months, and knee joint Lysholm score was used at 9 months after operation. Results: the TT-TG value of patients with recurrent patellar dislocation aged from 8 to 16 years was 25.27 鹵1.75mm, which was higher than that of patients with low age group (17.46 鹵1.14mm). There was no significant difference in the femoral trochlear angle, knee joint Lysholm score and patellar Kujala score before operation (all P 0.05). The patellar height and patellar obliquity angle in group A were decreased 3 months after operation. 24 months after operation, the patellar height of group A was 1.06 鹵0.15) and the patellar angle was 18.82 鹵2.15 擄), which was lower than that of group B (1.28 鹵0.20) and the angle of patellar inclination was 21.26 鹵2.18 擄(P 0.05). The Lysholm score of knee joint and Kujala score of patella were significantly higher than those of group A at 6 months after operation and 9 months after operation. After 12 months of operation, the excellent and good rate of group A was higher than that of group B. the number of patients with postoperative complications in group A was lower than that in group B. Conclusion: in adolescent patients with recurrent patellar dislocation, The value of TT-TG in the high age group was higher than that in the lower age group. The effect of patellar ligament 1/3 metastasis in the treatment of juvenile RPD patients was good within 24 months after operation.
【學位授予單位】：延邊大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R726.8
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本文編號：1545329