Grim C, Lorbach O, Engelhardt M
Klinik für Orthopädie, Unfall- und Handchirurgie, Klinikum Osnabrück, Am Finkenhügel 1, 49076 Osnabrück.
Orthopade. 2010 Dec;39(12):1127-34. doi: 10.1007/s00132-010-1690-5.
Ruptures of the quadriceps or patellar tendon are uncommon but extremely relevant injuries. Early diagnosis and surgical treatment with a stable suture construction are mandatory for a good postoperative clinical outcome. The standard methods of repair for quadriceps and patellar tendon injuries include the placement of suture loops through transpatellar tunnels. Reinforcement with either a wire cerclage or a PDS cord is used in patellar tendon repair. The PDS cord can also be applied as augmentation in quadriceps tendon repair. In secondary patellar tendon repair an autologous semitendinosus graft can be used. For chronic quadriceps tendon defects a V-shaped tendon flap with a distal footing is recommended. The different methods of repair should lead to early functional postoperative treatment. The clinical outcome after surgical treatment of patellar and quadriceps tendon ruptures is mainly good.
股四头肌或髌腱断裂并不常见,但却是极其重要的损伤。早期诊断并采用稳定的缝合结构进行手术治疗,对于获得良好的术后临床效果至关重要。股四头肌和髌腱损伤的标准修复方法包括通过髌腱隧道放置缝合环。髌腱修复中使用钢丝环扎或聚对二氧环己酮(PDS)线加强。PDS线也可用于股四头肌腱修复的增强。在二次髌腱修复中可使用自体半腱肌移植物。对于慢性股四头肌腱缺损,建议采用带远端基底的V形肌腱瓣。不同的修复方法应能实现术后早期功能治疗。髌腱和股四头肌腱断裂手术治疗后的临床效果总体良好。