Hung Nguyen Ngoc
Pediatric Orthopaedic, National Hospital For Pediatrics, 18/879 Lathanh Road, Hanoi, Vietnam,
J Child Orthop. 2008 Oct;2(5):343-51. doi: 10.1007/s11832-008-0106-0. Epub 2008 May 22.
To evaluate the clinical and functional results of surgical treatment of patellar dislocation in children.
A prospective study was undertaken from January 1995 to December 2004. Patients who suffered from patellar dislocation after receiving intramuscular antibiotic injections to quadriceps were recruited. A complete history of each patient was recorded, and both a clinical and a roentgenographic examination were performed preoperatively. Patellar dislocation was classified according to Bensahel's criteria. The iliotibial tract and lateral retinacula was released to restore the tension of the medial retinaculum. Quadricepsplasty was used in all patients for full flexion of knee.
There were nine males and 65 females in this study. All 74 patients (76 knees) developed dislocation of the patella after repeated intramuscular injections of antibiotic(s) into the quadriceps muscle. Fifty-six knees (73.7%) were type 1, and 20 knees (26.3%) were type 2 (Bensahel's classification). In all, we attained excellent results in 56 knees (73.7%), good results in 17 knees (22.4%), and fair results in three knees (3.9%). There have been no poor results or recurrences so far.
Use of the iliotibial tract, adequate lateral retinacular release, restoration of the tension of the medial retinaculum and associated quadricepsplasty achieved a high success rate. The technique is simple, safe and effective in skeletally immature children.
评估儿童髌骨脱位手术治疗的临床及功能结果。
1995年1月至2004年12月进行了一项前瞻性研究。招募了因股四头肌肌内注射抗生素后发生髌骨脱位的患者。记录每位患者的完整病史,并在术前进行临床和X线检查。根据本萨赫尔标准对髌骨脱位进行分类。松解髂胫束和外侧支持带以恢复内侧支持带的张力。所有患者均采用股四头肌成形术以实现膝关节的完全屈曲。
本研究中有9名男性和65名女性。所有74例患者(76膝)在股四头肌反复肌内注射抗生素后均发生髌骨脱位。56膝(73.7%)为1型,20膝(26.3%)为2型(本萨赫尔分类)。总体而言,56膝(73.7%)获得了优异结果,17膝(22.4%)获得了良好结果,3膝(3.9%)获得了尚可结果。目前尚无差的结果或复发情况。
使用髂胫束、充分松解外侧支持带、恢复内侧支持带的张力以及相关的股四头肌成形术取得了较高的成功率。该技术在骨骼未成熟的儿童中简单、安全且有效。