McCall R E, Ratts V
Shriners Hospitals for Children, Shreveport, Louisiana 71101, USA.
J Pediatr Orthop. 1999 Jul-Aug;19(4):549-52. doi: 10.1097/00004694-199907000-00026.
Patellar malalignment or instability is a frequent problem in adolescents. Patients with persistent symptoms require operative correction with procedures often requiring osteotomies of the tibial tubercle. Insall described a soft-tissue procedure to correct instability in adults, and others have used this in adolescents. Short-term results have seemingly been satisfactory in the skeletally immature population. A long-term outcome study was performed to evaluate the effectiveness of soft-tissue realignment for patellar instability in adolescents. From 1980 to 1996, 54 patients (65 knees) underwent Insall proximal-distal soft-tissue realignment. No concomitant bony or other soft-tissue procedures were performed. Follow-up averaged 6 years (range, 2-15 years), assessing stability, strength, range of motion, and congruence angle on the Merchant's view. Eighty-seven percent had a good to excellent result; 8%, a fair result; and 5%, poor results.
髌骨排列不齐或不稳定是青少年中常见的问题。有持续症状的患者需要通过手术进行矫正，手术通常需要对胫骨结节进行截骨术。英萨尔描述了一种用于矫正成人不稳定的软组织手术，其他人也将其用于青少年。在骨骼未成熟人群中，短期结果似乎令人满意。进行了一项长期结果研究，以评估软组织重新排列治疗青少年髌骨不稳定的有效性。1980年至1996年，54例患者（65膝）接受了英萨尔远近端软组织重新排列手术。未同时进行骨或其他软组织手术。随访平均6年（范围2至15年），评估稳定性、力量、活动范围以及Merchant位片上的适合角。87%的结果为良好至优秀；8%为一般；5%为差。
