关节镜辅助内侧髌股韧带双束联合股内侧肌斜束解剖重建治疗髌骨脱位的临床研究

《关节镜辅助内侧髌股韧带双束联合股内侧肌斜束解剖重建治疗髌骨脱位的临床研究》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、授予单位代码10089学号或申请号13216H妗(E搿大5HebeiMedicalUniversity学位论文在职科学学位关节镜辅助内侧髌股韧带双束联合股内侧肌斜束解剖重建治疗髌骨脱位的临床研究学位申请人：王芳芳导师：王飞教授专业：外科学二级学院：第三医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师（或指导小组）的指导下，由本人独立完成。本学位论文研究所获得的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文，第一署名为单位

2、河北医科大学，试验材料、原始数据、申报的专利等知识产权均归河北医科大学所有。否则，承担相应法律责任。y/

3、j刃巧"年f月70日目录中文摘要·······························

4、··············································1英文摘要·············································································3研究论文关节镜辅助内侧髌股韧带双束联合股内侧肌斜束解剖重建治疗髌骨脱位的临床研究前言·············································································6材料与方法·············

5、·······················································6结果·············································································12附图·············································································14附表···············································

6、······························17讨论·············································································18结论·············································································23参考文献·····································································

7、··23综述内侧髌股韧带临床重建治疗髌骨脱位的研究进展·················28致谢···················································································41个人简历·············································································42中文摘要关节镜辅助内侧髌股韧带双束联合股内侧肌斜束解剖重建治疗髌骨脱位的临床研究摘要目的：由于髌骨的运

8、动轨迹复杂性，周围软组织的调控多样性，髌骨脱位已成为骨科常见疾病，其治疗也成为骨科医生极大的挑战。随着近年对生物力学的研究发现，在限制髌骨外倾以及控制髌骨轨迹的内侧软组织中，内侧髌股韧带(MPFL)约占50%-60%的作用，因此重建MPFL也成为治疗髌骨脱位的主要手术选择。目前重建MPFL手术方法种类较多，而最近研究的双束解剖重建手术，近年来被越来越多学者所接受。MPFL双功能束概念，分为下直束及上斜束，而上斜束在髌骨止点附近与股内侧肌斜束(VMO)网状交叉联合，在屈膝的早期，VMO使在限制髌骨外移中的作用远远超过静态的50%，

9、所以重建MPFL时应注意VMO的重建。本文研究介绍，通过对MPFL双束解剖重建及VMO的联合重建，恢复髌骨内侧软组织的稳定性，同时辅以关节镜下探查关节内情况、髌骨位置、髌骨与股骨之间的对合关系等治疗髌骨脱位，同时通过术后随访观察其手术效果，进一步为临床应用提供较