Vermeulen Daan, van der Valk Mara Rosa, Kaas Laurens
Department of Orthopaedic Surgery, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands.
EFORT Open Rev. 2019 Mar 27;4(3):110-114. doi: 10.1302/2058-5241.4.180016. eCollection 2019 Mar.
With an incidence of 5.8 per 100,000 per year, patellar dislocations are commonly seen in the emergency department. Surprisingly, there are only a few studies available that focus on the results of the different non-surgical treatment options after first-time patellar dislocation. The aim of this review is to provide an overview of the most recent and relevant studies on the rationales and results of the non-surgical treatment for first-time patellar dislocation.Patellar instability mainly affects young and active patients, with a peak incidence of 29 per 100 000 per year in adolescents. The medial patellofemoral ligament, a main passive restraint for lateral translation of the patella, is torn in lateral patellofemoral dislocations. Treatment of first-time patellar dislocation can be either conservative or surgical.There are two options in conservative management of first-time patellar dislocation: immobilization using a cylinder cast or removable splint, or, second, functional mobilization after applying a brace or patellar tape.The current available literature of conservative treatment after a first-time patellar dislocation is little and of low quality of evidence. Conclusions should be drawn with care, new research focussing on non-surgical treatment is therefore strongly needed. Cite this article: 2019;4:110-114. DOI: 10.1302/2058-5241.4.180016.
髌股关节脱位的年发病率为每10万人中有5.8例，在急诊科较为常见。令人惊讶的是，仅有少数研究关注首次髌股关节脱位后不同非手术治疗方案的效果。本综述的目的是概述首次髌股关节脱位非手术治疗的理论依据和效果的最新相关研究。髌股关节不稳定主要影响年轻且活跃的患者，青少年的年发病率峰值为每10万人中有29例。髌股内侧韧带是髌骨向外侧移位的主要被动约束结构，在髌股外侧脱位时会发生撕裂。首次髌股关节脱位的治疗可以是保守治疗或手术治疗。首次髌股关节脱位的保守治疗有两种选择：使用石膏管型或可拆除夹板固定，或者在应用支具或髌骨贴布后进行功能活动。目前关于首次髌股关节脱位后保守治疗的现有文献较少且证据质量较低。得出结论时应谨慎，因此强烈需要专注于非手术治疗的新研究。引用本文：2019;4:110 - 114。DOI: 10.1302/2058 - 5241.4.180016。
