青少年复发性髌骨脱位TT-TG影像解剖学研究及临床意义

发布时间：2018-02-28 02:17

  本文关键词： 膝关节 青少年复发性髌骨脱位 胫骨结节-股骨滑车距离 髌韧带1/3转移术　出处：《延边大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探索青少年复发性髌骨脱位患者胫骨结节-股骨滑车距离的影像学的临床意义。方法:取自2012年01月至2014年12月本院骨一科收治复发性髌骨脱位患者共104例,全部患者利用X线检测髌骨高度和股骨滑车沟角,CT检测胫骨结节-股骨滑车距离、髌骨倾斜角。收集统计患者入院时的股骨滑车-胫骨结节距离数值并分析。对于临床资料研究根据年龄分为低年龄组(8-12岁,A组,N=51)和高年龄组(13-16岁,B组,N=53)。分析术前及术后3个月、6个月、9个月、12个月、24个月的髌骨高度、股骨滑车角、髌骨倾斜角和膝关节Lysholm评分及髌骨Kujala评分,两组患者术后并发症及术后功能恢复情况。全部患者随访24个月,在术后9个月采用膝关节Lysholm评分、髌骨Kujala评分进行优良率评定。结果:在8-16岁复发性髌骨脱位患者中高年龄组患者的TT-TG数值(25.27±1.75mm)大于低年龄组患者(17.46±1.14mm);两组患者性别、手术部位、体质指数、髌骨高度、髌骨倾斜角、股骨滑车角、膝关节Lysholm评分、髌骨Kujala评分等术前资料比较无统计学差异(均P0.05)。术后3个月A、B两组髌骨高度及髌骨倾斜角均较术前减小,术后24个月A组髌骨高度(1.06±0.15)及髌骨倾斜角(18.82±2.15°)均小于B组的髌骨高度(1.28±0.20)及髌骨倾斜角(21.26±2.18°),均有统计学差异(均P0.05)。膝关节Lysholm评分及髌骨Kujala评分在术后6个月,9个月A组的评分高于B组评分。使用术后12个月膝关节Lysholm评分进行优良率评定,A组优良率高于B组。A组术后出现并发症患者人数少于B组,以上差异均具有统计学意义(P0.05)。结论:在青少年复发性髌骨脱位患者中,高年龄组患者TT-TG数值较低年龄组患者更大。使用髌韧带1/3转移术治疗青少年RPD患者在术后24个月内手术效果良好。
[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 卤1.75mm, which was higher than that of patients with low age group (17.46 卤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 卤0.15) and the patellar angle was 18.82 卤2.15 掳), which was lower than that of group B (1.28 卤0.20) and the angle of patellar inclination was 21.26 卤2.18 掳(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.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R726.8
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