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[髌骨软骨病时股四头肌的神经支配紊乱。对髌骨软骨病当前概念的批判性评价]

[Innervation disturbances of the quadriceps muscle in chondropathia patellae. A critical appraisal of the current concept of chondropathia].

作者信息

Weh L, Eickhoff W

出版信息

Z Orthop Ihre Grenzgeb. 1983 Mar-Apr;121(2):171-6. doi: 10.1055/s-2008-1051335.

Abstract

In a group of patients with typical histories of chondropathy, but in whom no other criteria of selection were applied, evidence of neurogenic damage in the quadriceps muscle was found. Innervational damage was also found regularly in the corresponding segments of the paravertebral musculature. Only in three cases, in which horn cell damage was suspected, were there no changes in the paravertebral musculature. There were abnormal structural or functional findings in the lumbar spine in all the patients. A disequilibrium between the median and lateral vastus groups, attributable to innervation, was postulated and subsequently confirmed by electromyography. The nature of chondropathia patellae as an insertion tendopathy is discussed, taking the lack of concomitance of chondropathy and chondromalacia into consideration as well as the findings in the group of patients examined. Phenomena associated with chondropathy which have hitherto incongruous may be explained on the basis of an asymmetrical innervation disturbance.

摘要

在一组具有典型软骨病病史但未应用其他选择标准的患者中,发现股四头肌存在神经源性损伤的证据。在椎旁肌肉组织的相应节段也经常发现神经支配损伤。仅在3例怀疑有角细胞损伤的病例中,椎旁肌肉组织未出现变化。所有患者的腰椎均有结构或功能异常发现。推测并随后经肌电图证实,由于神经支配,股内侧肌和股外侧肌组之间存在失衡。考虑到软骨病和软骨软化症缺乏伴发性以及所检查患者组的检查结果,讨论了髌软骨病作为一种附着肌腱病的性质。迄今为止不一致的与软骨病相关的现象可以基于不对称的神经支配紊乱来解释。

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