改良Judet股四头肌成形术加髌骨牵引治疗膝关节挛缩

Bari Mm, I. Shahidul, Azad Mohammad Abul Kalam, A. Tanvir, Bari A M Shayan R
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摘要

目的观察改良Judet四头肌成形术(MJQP)在BARI-ILIZAROV骨科中心髌骨牵引治疗膝关节伸展挛缩症的临床效果。材料和方法:2015年1月至2021年1月,我们在我们的BARI-ILIZAROV骨科中心接受了16例膝关节伸展挛缩症患者的MJQP髌骨牵引治疗。翻修手术的年龄为25-58岁。MJQP治疗骨折的间隔时间为4至20个月,我们的随访时间为10至30个月。我们评估了术前和术后的活动范围(ROM)。结果:术前MJQP后膝关节活动范围为5-50(35±10)°,35-85(55±10)度,平均0-35(18+10)°。我们应用髌骨牵引12-14(10±3)°。当我们移除髌骨牵引时,当时的膝盖运动范围为95-110(93±4)°,与关节内所有关节纤维化解除后的运动范围相比,增加了10-70。我们的随访时间为12-35(19±5)个月。第一次随访时,膝关节的活动范围为85-135(105±13)°,与术前相比增加了45-105(70±15)°,而与髌骨牵引移除后的活动范围相比增加了10-45(12±12)°。膝关节功能优良12例(70%),良好3例(27%),尚可1例(3%)。结论:MJQP配合髌骨牵引延长收缩的股四头肌,术后护理及CPM治疗效果良好。
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Modified Judet’s Quadricepsplasty with patella traction for extension contracture of knee
To see the clinical result of Modified Judet’s Quadricepsplasty (MJQP) with patella traction at BARI-ILIZAROV ORTHOPAEDIC CENTRE for the treatment of knee extension contracture. Materials and methods: We received 16 patients with knee extension contracture treated by MJQP with patella traction from January 2015 to January 2021, at our BARI-ILIZAROV ORTHOPAEDIC CENTRE. The age at revision surgery was 25-58 years. The time between fracture treatment to MJQP was 4 to 20 months and our follow up was 10-30 months. We assessed pre-operative and post-operative range of motion (ROM). Results: Knee range of motion pre-operatively was 5-50 (35± 10)° and 35-85 (55±10)° after MJQP and in average of 0-35(18+10) °. We applied patella traction for 12-14 (10±3)° When we removed the patella traction the knee range of motion at that time was 95-110 (93±4)° and increase of 10-70 compared with the range of motion after release of all arthrofibrosis in the joint. Our follow up time was 12-35 (19±5) months. Knee range of motion at first follow up was 85-135 (105±13)°, an increase of 45-105 (70±15) ° compared with pre-operatively and of 10-45 (12±12)° compared with the range of motion after patella traction removed. Knee function was excellent in 12 cases (70%), good in 3 (27%) and fair in one (3%). Conclusion: MJQP with patella traction lengthens the contracted Quadriceps femoris gives excellent result with proper post-operative care and CPM therapy.
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