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：

髌韧带断裂; Y形筋膜瓣; 重建

DOI：

10.7507/1002-0179.20130312

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目的　评价股外侧肌远端筋膜瓣折叠修复重建陈旧性髌韧带断裂的安全性及临床疗效。方法　对2008年6月－2010年10月收治的10 例陈旧性髌韧带断裂患者，采用股外侧肌远端筋膜瓣折叠联合减张钢丝张力带固定方法重建髌韧带。术后1、2、3、6及12个月随访，采用美国膝关节协会评分对膝关节功能进行评分，包括膝关节疼痛、行走能力和上下楼梯能力、活动度等，同时行超声检查对膝关节髌韧带的连续性进行评估。结果　10例患者中9 例获得随访，平均随访12个月（6～15个月）。末次随访时平均膝关节疼痛评分、功能评分、膝关节活动范围均较术前明显改善。超声检查显示所有患者肌腱完全愈合，连续性完好，不需要进一步外科手术干预。所有随访患者均未发生手术相关并发症。结论　采用股外侧肌远端筋膜瓣折叠重建陈旧性髌韧带断裂是一种有效、可靠的方法，能够恢复良好的膝关节功能。

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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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.
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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. 　陈孙裕, 李坚, 肖展豪, 等. 异体跟腱骨移植修复髌韧带近止点断裂[J]. 生物骨科材料与临床研究, 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. 　王献伟. 腓肠肌内侧头皮瓣转位修复髌韧带及膝前内侧皮肤缺损[J]. 中国实用医药, 2011, 6(32): 64-65.
8. 　朱庆军, 霍文玲. 胫骨结节前内侧移位术与内侧髌股韧带重建术治疗髌股关节对合不良初期临床疗效分析[J]. 河北医药, 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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