The Clinical Outcome of Anatomical Reconstruction of the Patellar Tendon Using a Y-shaped Flap Folded Back from the Vastus Lateralis Fascia_West China Medical Journal

Authors：

YU Jianxiang , TANG Dajun.

Department of Orthopedics, the First Hospital of Liangshan, Xichang, Sichuan 615000, P. R. China;

Corresponding?author：

Keywords：

髕韌帶斷裂; Y形筋膜瓣; 重建

DOI：

10.7507/1002-0179.20130312

Video：

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目的　評價股外側肌遠端筋膜瓣折疊修復重建陳舊性髕韌帶斷裂的安全性及臨床療效。方法　對2008年6月－2010年10月收治的10 例陳舊性髕韌帶斷裂患者，采用股外側肌遠端筋膜瓣折疊聯合減張鋼絲張力帶固定方法重建髕韌帶。術后1、2、3、6及12個月隨訪，采用美國膝關節協會評分對膝關節功能進行評分，包括膝關節疼痛、行走能力和上下樓梯能力、活動度等，同時行超聲檢查對膝關節髕韌帶的連續性進行評估。結果　10例患者中9 例獲得隨訪，平均隨訪12個月（6～15個月）。末次隨訪時平均膝關節疼痛評分、功能評分、膝關節活動范圍均較術前明顯改善。超聲檢查顯示所有患者肌腱完全愈合，連續性完好，不需要進一步外科手術干預。所有隨訪患者均未發生手術相關并發癥。結論　采用股外側肌遠端筋膜瓣折疊重建陳舊性髕韌帶斷裂是一種有效、可靠的方法，能夠恢復良好的膝關節功能。

Citation： YU Jianxiang,TANG Dajun.. The Clinical Outcome of Anatomical Reconstruction of the Patellar Tendon Using a Y-shaped Flap Folded Back from the Vastus Lateralis Fascia. West China Medical Journal, 2013, 28(7): 1008-1010. doi: 10.7507/1002-0179.20130312 Copy

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1. 　Casey MT, Tietjens BR. Neglected ruptures of the patellar tendon. A case series of four patients[J]. Am J Sports Med, 2001, 29(4): 457-460.
2. 　Hockings M, Cameron JC. Patella baja following chronic quadriceps tendon rupture[J]. Knee, 2004, 11(2): 95-97.
3. 　Oni OO, Ahmad SH. The vastus lateralis derived ?ap for repair of neglected rupture of the quadriceps femoris tendon[J]. Surg Gynecol Obstet, 1985, 161(4): 385-387.
4. 　Gemmill TJ, Carmichael S. Complete patellar ligament replacement using a fascia lata autograft in a dog[J]. J Small Anim Pract, 2003, 44(10): 456-459.
5. 　陳孫裕, 李堅, 肖展豪, 等. 異體跟腱骨移植修復髕韌帶近止點斷裂[J]. 生物骨科材料與臨床研究, 2011, 8(6): 14-15,19.
6. 　Williams RJ, Brooks DD, Wickiewicz TL. Reconstruction of the patellar tendon using a patella-quadriceps tendon autograft[J]. Orthopedics, 1997, 20(6): 554-558.
7. 　王獻偉. 腓腸肌內側頭皮瓣轉位修復髕韌帶及膝前內側皮膚缺損[J]. 中國實用醫藥, 2011, 6(32): 64-65.
8. 　朱慶軍, 霍文玲. 脛骨結節前內側移位術與內側髕股韌帶重建術治療髕股關節對合不良初期臨床療效分析[J]. 河北醫藥, 2010, 32(20): 2829-2831.
9. 　Greis PE, Lahav A, Holmstrom MC. Surgical treatment options for patella tendon rupture, part Ⅱ: chronic[J]. Orthopedics, 2005, 28(8): 765-769.
10. 　Greis PE, Lahav A, Holmstrom MC. Surgical treatment options for patella tendon rupture, part Ⅱ:chronic[J]. Orthopedics, 2005, 28(8): 765-769.
11. 　Burnett RS, Berger RA, PaproskyWG, et al. Extensor mechanism allograft reconstruction after total knee arthroplasty. A comparison of two techniques[J]. J Bone Joint Surg Am, 2004, 86A(12): 2694-2699.
12. 　Hess P, Reinders J. Transposition of the sartorius muscle for reconstruction of the extensor apparatus of the knee[J]. J Trauma, 1986, 26(1): 90-92.
13. 　Jaureguito JW, Dubois CM, Smith SR, et al. Medial gastrocnemius transposition flap for the treatment of disruption of the extensor mechanism after total knee arthroplasty[J]. J Bone Joint Surg Am, 1997, 79(6): 866-873.

West China Medical Journal

The Clinical Outcome of Anatomical Reconstruction of the Patellar Tendon Using a Y-shaped Flap Folded Back from the Vastus Lateralis Fascia

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