Lobenhoffer P, Thermann H
Klinik für Unfall- und Wiederherstellungschirurgie, Henriettenstiftung Hannover.
Orthopade. 2000 Mar;29(3):228-34. doi: 10.1007/s001320050441.
Ruptures of the quadriceps as well as the patellar tendon occur in low frequency, but cause major functional deficits of the leg. These injuries usually require operative treatment. Acute quadriceps tendon ruptures are treated by suture repair, using heavy sutures guided through bone tunnels in the patella. Chronic defects and neglected cases require a local tendon transfer, either by a quadriceps tendon turn-down or by a V-Y-plasty of the quadriceps tendon. Ruptures of the patellar tendon are treated by suture of the tendon stumps plus an reinforcement procedure protecting the tendon and avoiding secondary patella alta. Patello-tibial fixation may be achieved by a cerclage technique using wire or an autologous tendon strip, alternatively a patello-tibial external fixator can be applied. In chronic and neglected cases, patellar tendon reconstruction is performed with autologous tendon grafts or with soft tissue allografts. The graft must be protected by a patello-tibial fixation for the first weeks.
股四头肌和髌腱断裂虽发生率较低，但会导致腿部严重功能障碍。这些损伤通常需要手术治疗。急性股四头肌肌腱断裂通过缝线修复治疗，使用粗缝线经髌骨骨隧道引导。慢性缺损及延误治疗的病例需要进行局部肌腱转移，可采用股四头肌肌腱翻转或股四头肌肌腱V-Y成形术。髌腱断裂通过缝合肌腱残端并加强肌腱的方法治疗，以保护肌腱并避免继发高位髌骨。可采用钢丝或自体肌腱条的环扎技术实现髌胫固定，也可应用髌胫外固定器。在慢性及延误治疗的病例中，采用自体肌腱移植物或软组织同种异体移植物进行髌腱重建。术后最初几周移植物必须通过髌胫固定加以保护。
