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目的评价髌腱内移和髌内侧筋膜肌肉瓣外移术治疗先天性髌骨脱位的效果。方法自1994年6月～1998年6月,采用髌腱内移和内侧筋膜肌肉瓣外移的方法治疗先天性髌骨脱位5例,男2例,女3例,平均年龄7岁(4～10岁)。4例为单侧髌骨脱位,1例为双侧(只治疗一侧),均未合并其它畸形。结果术后随访1.5～5年,平均3年,无手术并发症,无术后再脱位和半脱位。4例膝关节能完全伸直,1例差10°;2例膝外翻消失;1例10岁女童术后出现髌骨低位,但膝外翻消失、功能正常且伸膝有力。结论先天性髌骨脱位是一种持续、不可复性脱位,需手术治疗。髌内侧筋膜肌肉瓣外移和髌腱内移术操作简单,损伤较小,并发症少,效果优良,是一种值得推荐的手术方法。
Objective To evaluate the effect of patellar tendon transfer and medial patellar fasciocutaneous flap for the treatment of congenital patellar dislocation. Methods From June 1994 to June 1998, 5 cases of congenital patellar dislocation were treated with patellar tendon inset and medial fascia flap. There were 2 males and 3 females, with an average age of 7 years (range, 4 ~ 10 years old). 4 cases were unilateral patellar dislocation, 1 case was bilateral (only treated side), did not merge with other deformities. Results Postoperative follow-up 1.5 to 5 years, an average of 3 years, no surgical complications, no dislocation and subluxation after surgery. 4 cases of knee joint can be completely straightened, 1 case difference of 10 °; 2 cases of valgus disappeared; 1 case of 10-year-old girl had patella low postoperatively, but the disappearance of the knee valgus, normal function and knee extensor. Conclusions Congenital dislocation of the patella is a continuous, irreversible dislocation, requiring surgical treatment. The patellar medial fascia flap and patellar tendon transfer surgery is simple, less damage, fewer complications, the effect is good, is a recommended surgical method.