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[不同条件下Q角在复发性髌骨脱位中的临床意义]

[Clinical significance of Q-angle under different conditions in recurrent patellar dislocation].

作者信息

Wang Zhijie, Chen You, Li Anping, Long Yi

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2014 Jan;28(1):17-20.

Abstract

OBJECTIVE

To investigate the clinical significance of Q-angle measuring under different conditions in female recurrent patellar dislocation female patients.

METHODS

Between August 2012 and March 2013, 10 female patients (11 knees) with recurrent patellar dislocation were collected as trial group; 20 female patients (20 knees) with simple meniscus injury were collected as control group at the same time. Q-angle was measured in extension, 30 degrees flexion, 30 degrees flexion with manual correction, and surgical correction in the trial group, and only in extension and 30 degrees flexion in the control group. Then the difference value of Q-angle between extension and 30 degrees flexion (Q-angle in extension subtracts Q-angle in 30 flexion) were calculated. Independent sample t-test was used to analyze Q-angle degrees in extension, 30 degrees flexion, and the changed degrees of 2 groups. The Q-angle between manual correction and surgical correction of the trial group was analyzed by paired t-test.

RESULTS

The Q-angle in extension, Q-angle in 30 degrees flexion, and difference value of Q-angle between extension and 30 degrees flexion were (17.2 +/- 3.6), (14.3 +/- 3.0), and (2.9 +/- 1.9) degrees in the trial group and were (15.2 +/- 3.4), (14.4 +/- 3.5), and (0.8 +/- 1.7) degrees in the control group. No significant difference was found in Q-angle of extension or Q-angle of 30 degrees flexion between 2 groups (P > 0.05), but the difference value of Q-angle between extension and 30 degrees flexion in the trial group was significantly larger than that in the control group (t = 3.253, P = 0.003). The Q-angle in 30 degrees flexion with manual correction and surgical correction in the trial group was (19.8 +/- 3.4) degrees and (18.9 +/- 3.8) degrees respectively, showing no significant difference (t = 2.193, P = 0.053).

CONCLUSION

When a female patient's Q-angle in 30 degrees flexion knee changes obviously compared with Q-angle in extension position, recurrent patellar dislocation should be considered. For female patients with recurrent patellar dislocation, the preoperative Q-angle in 30 degrees flexion with manual correction should be measured, which can help increasing the accuracy of evaluation whether rearrangement should be performed.

摘要

目的

探讨不同条件下测量Q角在复发性髌骨脱位女性患者中的临床意义。

方法

2012年8月至2013年3月,收集10例复发性髌骨脱位女性患者(11膝)作为试验组;同期收集20例单纯半月板损伤女性患者(20膝)作为对照组。试验组在伸直位、屈膝30°、手法矫正屈膝30°及手术矫正时测量Q角,对照组仅在伸直位和屈膝30°时测量。然后计算伸直位与屈膝30°时Q角的差值(伸直位Q角减去屈膝30°时Q角)。采用独立样本t检验分析两组伸直位、屈膝30°时的Q角度数及变化度数。试验组手法矫正与手术矫正时的Q角采用配对t检验分析。

结果

试验组伸直位Q角、屈膝30°时Q角及伸直位与屈膝30°时Q角差值分别为(17.2±3.6)°、(14.3±3.0)°、(2.9±1.9)°,对照组分别为(15.2±3.4)°、(14.4±3.5)°、(0.8±1.7)°。两组伸直位Q角及屈膝30°时Q角比较差异无统计学意义(P>0.05),但试验组伸直位与屈膝30°时Q角差值明显大于对照组(t=3.253,P=0.003)。试验组手法矫正屈膝30°及手术矫正时Q角分别为(19.8±3.4)°和(18.9±3.8)°,差异无统计学意义(t=2.193,P=0.053)。

结论

女性患者屈膝30°时Q角与伸直位相比变化明显时,应考虑复发性髌骨脱位。对于复发性髌骨脱位女性患者,术前应测量手法矫正屈膝30°时的Q角,有助于提高评估是否应进行复位的准确性。

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