髌上囊重建及髌旁支持带成形治疗创伤后膝关节僵直

目的]探讨联合成形术治疗创伤后膝关节僵直的方法和疗效.方法]采用膝关节前内侧切口,切开股直肌与股内外侧肌之间的腱性部分,切开两侧髌旁支持带,进行松解,屈曲膝关节手法松解胫股间及后关节囊粘连,切取股骨髁上筋膜脂肪垫,翻转缝合重建髌上囊.再将髌旁支持带分成深、浅两层,将浅层向前翻转缝合完成髌旁支持带成形,膝关节屈曲可达120～140°.结果]本组42例患者,平均随访18个月,平均膝关节屈曲度由术前的35°增至115°,平均增加85°,膝关节功能明显改善.结论]髌上囊重建与髌旁支持带成形是治疗创伤后膝关节僵直的有效方法.

Suprapatellar bursa reconstruction and patella retinacula plastic operation for the treatment of knee joint ankylosis after injury

Objective]To investigate the method and the clinical result of unification plastic operation of knee ankylosis after injury.Method]Knee joint anterior-medial incision was selected and the tendinous tissue between rectus femofis and vastus lateralis/medialis was cut through,amphi-patella retinacula was incised and released.The adhesion among tibia,femur and posterior joint capsules was released by maneuver flexion.The fascia fat pad on femur condyle was cut and reversed to reconstruct the suprapatellar bursa.Patella retinacula was divided into deep and superficial layers,and then the superficial layer was reversed forward and sutured,the patella retinacula plastic operation was completed.Knee joint flexion resumed again which ranged from 120 to 140.Result]All of the 42 cases were followed up for about 18 months.The average flexional function of the knee joint improved from 35 preoperatively to 115 postoperatively,which increased by 85.The result was satisfactory.Conclusion]Suprapatellar bursa reconstruction and patella retinacula plastic operation is a good method to treat the post-traumatic knee ankylosis.