Bonnard C, Nocquet P, Sollogoub I, Glorion B
Unité d'Orthopédie pédiatrique, Centre de Pédiatrie Gatien-de-Clocheville, Tours.
Rev Chir Orthop Reparatrice Appar Mot. 1990;76(7):473-9.
Before bony maturity, the treatment of the recurrent dislocation of the patella is based on tendinous transfers. These distal procedures were often combined with proximal procedures on the medial or lateral patellar retinaculum and vastus medialis muscle. For the purpose of analysing efficacity of the medial third tendon transfer to the distal and deep part of the medial collateral ligament before the bony maturity, 24 children have been reviewed with a post operative follow up of 14 months to 6 and half years. There were 4 boys and 20 girls between 7 to 15 years old at the time of surgery. The troubles duration before the operation was from a few days to 4 years and the pathology was very often bilateral (40 knees). The recurrent dislocation of the patella was present 6 times, an instability 25 times and a traumatic dislocation 9 times. The technical procedure was every time a stabilisation with the transfer of medial third of the patellar tendon, associated except in 6 cases with a correction of the patellar motion by patellar retinaculum plasties. The functional result has been evaluated according to the sport activity and the ordinary life, with very hard criteria according to patient's age. Twenty-four times the result was excellent (60 per cent), 8 times good (20 per cent) and fair 8 times. Two complications have been observed. The improvement of the trochlea angle, and the trochlea deepness have been significant. Sixteen patients (27 knees) have been reviewed after the bony maturity and no growth disturbance of the tibial tuberosity has been observed.(ABSTRACT TRUNCATED AT 250 WORDS)
在骨骼成熟之前,复发性髌骨脱位的治疗基于肌腱转移。这些远端手术通常与髌骨内侧或外侧支持带以及股内侧肌的近端手术相结合。为了分析在骨骼成熟之前将髌腱内侧三分之一转移至内侧副韧带远端和深部的疗效,对24名儿童进行了回顾性研究,术后随访时间为14个月至6年半。手术时年龄在7至15岁之间,有4名男孩和20名女孩。术前症状持续时间从几天到4年不等,且病变常常是双侧的(40个膝关节)。复发性髌骨脱位出现6次,不稳定25次,创伤性脱位9次。每次手术均采用髌腱内侧三分之一转移进行稳定治疗,除6例患者外,均联合髌骨支持带成形术矫正髌骨运动。根据运动活动和日常生活情况评估功能结果,根据患者年龄采用非常严格的标准。结果24次为优秀(60%),8次为良好(20%),8次为中等。观察到2例并发症。滑车角和滑车深度有显著改善。对16例患者(27个膝关节)在骨骼成熟后进行了复查,未观察到胫骨结节生长障碍。(摘要截短至250字)