【摘要】 目的探讨单侧髌骨骨折合并膝关节韧带和半月板损伤的患者术后对双侧膝关节功能的远期影响。方法回顾性分析2003年至2012年收治的单侧髌骨骨折合并膝关节交叉韧带和(或)半月板损伤患者39例,男26例,女13例;平均年龄(51.08±16.36)岁;左侧28例,右侧11例。记录患者末次随访时双侧股四头肌肌力、髌骨上缘近端10 cm、20 cm处大腿周径,进行相关膝关节评分并拍摄患膝X线片,评估患者患肢膝关节功能和影像学情况。结果 39例患者平均随访7～12年,末次随访时患者患侧髌骨上缘10 cm、20 cm处大腿周径分别为(41.82±5.31)cm和(56.87±3.23)cm,健侧髌骨上缘10 cm、20 cm处大腿周径分别为(43.74±4.83)cm和(57.38±3.84)cm,双侧比较两项数值差异均无统计学意义(P>0.05)。所有患者双侧股四头肌肌力均为5级。患者患侧AKS评分为(155.54±20.14)分,健侧为(160.08±13.07)分,差异无统计学意义(t=1.181,P=0.241)。患者患侧VAS评分为(3.31±1.98)分,健侧为(3.28±2.28)分,两侧对比差异无统计学意义(t=0.053,P=0.958)。双膝骨关节炎按照K-L分级标准,患侧关节炎情况明显更重(P=0.037)。结论单侧髌骨骨折合并膝关节交叉韧带和(或)半月板损伤的患者术后,长期随访患侧股四头肌力量和膝关节功能可以恢复至与健侧相当的水准,但患侧膝关节退变更为明显。更多还原

【Abstract】 Objective To investigate the effects of unilateral patella fracture associated with knee ligament and meniscus injury on the long-term function of bilateral knee joints after surgery.Methods A retrospective analysis was performed on 39 patients with unilateral patellar fracture complicated by cruciate ligament and/or meniscus injury of the knee joint who were admitted and treated in our hospital from 2003 to 2012,including 26 males and 13 females,with an average age being(51.08±16.36)years,and 28 cases on the left side and 11 cases on the right side.At the last follow-up,the bilateral quadriceps muscle strength and thigh circumference at 10 cm and 20 cm at the proximal end of the upper margin of the patella were recorded,and relevant knee joint scores were observed,moreover,the X-ray of the affected knee was performed to evaluate the knee joint function and imaging status of the affected limb.Results The mean follow-up time of 39 patients was 9.26 years(7～12 years).At the last follow-up,the circumference of the thigh at 10 cm and 20 cm at the upper margin of the affected side of the patella was(41.82±5.31)cm and(56.87±3.23)cm,respectively,and the circumference of the thigh at 10 cm and 20 cm at the upper margin of the healthy side of the patella was(43.74±4.83)cm and(57.38±3.84)cm,respectively,there were no significant differences in these indexes between the two sides(P>0.05).All the patients had grade 5 quadriceps muscle strength on both sides.The AKS scores of the affected side were 155.54±20.14,and those of healthy side were 160.08±13.07, there were no significant differences between the two sides(P>0.05).The VAS scores of the affected side were 3.31±1.98,and those of healthy side were 3.28±2.28, there were no significant differences between the two sides(P>0.05).According to the K-L grading standard,the osteoarthritis of the affected side was significantly severer(P<0.05).Conclusion In the patients with unilateral patellar fracture complicated by knee cruciate ligament and/or meniscus injury,the quadriceps muscle strength and knee joint function of the affected side can be restored to the same level as that of healthy side according to the results of long-term follow-up,but the changes of knee joint regression are more obvious.更多还原