影响改良汤普森股四头肌成形术治疗膝关节伸直挛缩效果的预后因素
Prognostic Factors Affecting the Results of Modified Thompson Quadricepsplasty for the Treatment of Extension Contracture of the Knee.
作者信息
Birjandinejad Ali, Ebrahimzadeh Mohammad H, Sayyed-Hosseinian Sayyed-Hadi, Tabesh Saman, Ghanbarifard Maryam
机构信息
Orthopedic Research Center, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
出版信息
Arch Bone Jt Surg. 2017 Mar;5(2):109-113.
BACKGROUND
Knee extension contracture is a disabling complication after fractures around the knee. In this study we aimed to study factors influencing the outcomes of quadricepsplasty for the treatment of traumatic knee extension contracture. We hypothesized that there is no factor influencing the final range of knee motion.
METHODS
In this retrospective study, we included 64 patients who underwent modified Thompson quadricepsplasty between 2008 to 2011 with a mean follow-up time of 36 months.
RESULTS
The mean change in flexion was 66 degrees. Using Judet criteria, results were excellent in 41 patients (64%), good in 15 (23%), fair in 4 (6%) and poor in 4 (6%). Preoperative arc of flexion, duration of extension contracture, number of previous surgeries on the limb, and BMI of the patients were independently influencing the final flexion.
CONCLUSION
Modified Thompson quadricepsplasty is associated with high number of excellent and good results especially when it is performed earlier in more severe contractures. Preoperative arc of flexion, interval between trauma surgery and quadricepsplasty, the number of prior surgeries, and BMI influence the outcomes of quadricepsplasty.
背景
膝关节伸直挛缩是膝关节周围骨折后一种导致功能障碍的并发症。在本研究中，我们旨在探讨影响股四头肌成形术治疗创伤性膝关节伸直挛缩疗效的因素。我们假设不存在影响膝关节最终活动范围的因素。
方法
在这项回顾性研究中，我们纳入了2008年至2011年间接受改良汤普森股四头肌成形术的64例患者，平均随访时间为36个月。
结果
屈曲平均改善66度。采用朱代标准，41例（64%）结果为优，15例（23%）为良，4例（6%）为中，4例（6%）为差。术前屈曲弧度、伸直挛缩持续时间、肢体既往手术次数以及患者的体重指数均独立影响最终屈曲度。
结论
改良汤普森股四头肌成形术有大量优和良的结果，尤其是在更严重挛缩时早期进行手术。术前屈曲弧度、创伤手术与股四头肌成形术之间的间隔时间、既往手术次数以及体重指数会影响股四头肌成形术的疗效。
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