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[目的]探讨自体半腱肌腱游离移植重建内侧髌股韧带治疗儿童复发性髌骨脱位的疗效和安全性。[方法]2008年2月~2010年2月治疗复发性髌骨脱位患儿7例。术中关节镜探查髌骨轨迹,处理合并损伤。行外侧支持带松解,自体半腱肌腱游离移植重建内侧髌股韧带。股骨侧避开骺软骨放置3.5 mm锚钉,髌骨内缘钻2个4.5 mm骨道,髌骨复位后将肌腱穿入骨道打结固定。[结果]随访12~24个月(平均17个月),手术效果满意,无复发脱位,无骨骺早闭,术后X线片示髌股关节解剖关系恢复正常。[结论]关节镜探查结合外侧支持带松解和自体半腱肌腱游离移植重建内侧髌股韧带治疗儿童复发性髌骨脱位,方法简单安全,疗效可靠。
[Objective] To investigate the efficacy and safety of free semitendinosus tendon graft in the treatment of recurrent patellar dislocation in children with reconstruction of the medial patellofemoral ligament. [Method] From February 2008 to February 2010, 7 children with recurrent patellar dislocation were treated. Intraoperative arthroscopy patellar trajectory, treatment of combined injury. External support line with release, the free semitendinosus tendon graft reconstruction medial patellofemoral ligament. 3.5 mm anchor was placed on the femur to avoid epiphyseal cartilage, and 2 4.5 mm osteotomy was performed on the medial edge of the patella. After the patella was reset, the tendon was inserted into the bone and tied for fixation. [Results] All cases were followed up for 12 to 24 months (average 17 months). The surgical results were satisfactory, no recurrence and dislocation, and no epiphyseal early closure. The postoperative X-ray showed the anatomy of the patellofemoral joint returned to normal. [Conclusion] Arthroscopic exploration combined with the release of the lateral support band and the free semitendinosus tendon graft in the reconstruction of the medial patellofemoral ligament in children with recurrent patellar dislocation, the method is simple and safe, the curative effect is reliable.