骨科

[摘要]先天性髕骨脫位（Congenital dislocation of the patella,CDP）是一種罕見的疾病，病因不明，多認(rèn)為是膝關(guān)節(jié)生長發(fā)育異常造成的一種持續(xù)性、不可復(fù)性的脫位，以雙側(cè)多見，具有一定的家族遺傳傾向。由于其早期診斷困難，隨著患兒的生長發(fā)育，導(dǎo)致一系列膝關(guān)節(jié)畸形，增加手術(shù)治療難度。本文參考國內(nèi)外相關(guān)研究文獻(xiàn)對(duì)先天性髕骨脫位的診斷及治療現(xiàn)狀進(jìn)行綜述，為臨床治療提供幫助，并對(duì)其前景作一展望。[關(guān)鍵詞]髕骨；脫位；治療；診斷Present situation and the research progress in diagnosis and treatment of congenital dislocation of the patellaHuang Chang-zhi1,Lin Quan1,Yang Xiao-ning2.1First Department of Orthopaedics,Ningde Hospital Affiliated to Fujian Medical University,NingdeFujian,352100;2First Department of Orthopaedics,the FirstPeople’s Hospital of Xuzhou,Xuzhou Medical University,XuzhouJiangsu,221002,China[Abstract]Congenital dislocation of the patella is a rare disease,and its etiology is not completely clear.It is considered to be a persistent and non-complex dislocation caused by the abnormal growth and development of the knee joint,which common on both sides with a genetic predisposition.Due to the difficulties in early diagnosis,with the growth and development of children,resulting in a series of knee deformities,therefore increasing the difficulty of surgical treatment.This article discusses the current development and future for the diagnosis and treatment of congenital dislocation of the patella in order to provide help for clinical treatment.[Keywords]Patella;Dislocations;Treatment;Diagnosis

摘要：目的探討青少年習(xí)慣性髕骨脫位的手術(shù)方式選擇及臨床療效。方法筆者醫(yī)院于2015-12收治1例青少年習(xí)慣性髕骨脫位，采用五聯(lián)法手術(shù)（膝外側(cè)軟組織松解術(shù)+內(nèi)側(cè)軟組織緊縮術(shù)+Roux-Goldthwait手術(shù)+內(nèi)側(cè)髕股韌帶重建術(shù)+股內(nèi)側(cè)肌下移術(shù)）治療，回顧性分析臨床資料并復(fù)習(xí)文獻(xiàn)。結(jié)果經(jīng)18個(gè)月隨訪膝關(guān)節(jié)功能恢復(fù)良好，無神經(jīng)、血管損傷，無切口感染，無髕骨脫位復(fù)發(fā)等不良事件發(fā)生。結(jié)論經(jīng)五聯(lián)法手術(shù)治療青少年習(xí)慣性髕骨脫位療效滿意，但手術(shù)方式的選擇應(yīng)視具體情況而定。

摘要： 目的 探討人工全髖關(guān)節(jié)置換術(shù)（THR）治療股骨粗隆間骨折伴股骨頭壞死的方法及療效。方法對(duì)15 例股骨粗隆間骨折伴股骨頭壞死行THR。均采用生物型髖臼假體及骨水泥或生物型股骨柄，骨折均采用鋼纜固定。結(jié)果假體均正確放置，無術(shù)中再骨折及神經(jīng)損傷。術(shù)后4~6 周可扶拐下床進(jìn)行早期功能鍛煉。均獲隨訪8~36 個(gè)月，Harris 評(píng)分：優(yōu)11例，良4 例。結(jié)論對(duì)此類患者行一次性THR，雖然增加了難度及一定的危險(xiǎn)性，但可減少并發(fā)癥及二次手術(shù)的痛苦。