Bensahel H, Souchet P, Pennecot G F, Mazda K
Service de Chirurgie Orthopédique, Hôpital Robert Debré, Paris, France.
J Pediatr Orthop B. 2000 Oct;9(4):265-70. doi: 10.1097/01202412-200010000-00010.
The authors reviewed 102 unstable patellas which had been observed and treated from 1964 to 1990. They were divided according to whether they suffered from traumatic dislocations, recurrent dislocations or malformative instability. The clinical findings were the major stage of the check up. In the field of imaging, standard X-rays had to be performed in all cases. MRI was of interest in the congenital dislocations, in order to thoroughly investigate the soft tissue anomalies. Two types were described: Type 1 was observed in children with joint laxity, but without major X-ray anomalies; Type 2, a major femoropatellar dysplasia could be formed with some bone deformity. The latter was observed in the malformative instability. Four different surgical procedures have been used, from the release of the retinacula of patella to the medial displacement of the patellar tendon or the tibial tuberosity. This study emphasises the concept of a true development dysplasia of patella (DDP) which can gather the different varieties of the instability of patella.
作者回顾了1964年至1990年间观察和治疗的102例不稳定髌骨病例。根据其病因是创伤性脱位、复发性脱位还是畸形性不稳定进行分组。临床检查结果是检查的主要阶段。在影像学方面，所有病例均需进行标准X线检查。对于先天性脱位，MRI有助于全面研究软组织异常情况。文中描述了两种类型：1型见于关节松弛但无明显X线异常的儿童；2型则伴有一些骨骼畸形，可形成严重的股骨髌骨关节发育不良，后者见于畸形性不稳定。已采用了四种不同的手术方法，从髌支持带松解到髌腱或胫骨结节的内侧移位。本研究强调了真正的髌骨发育不良（DDP）这一概念，它涵盖了髌骨不稳定的不同类型。
