以Judet股四頭肌成形術治療外傷性膝關節僵直症之初步探討—五病例報告

膝關節僵直症，不但給病人帶來生活上的不便，往往在治療上也給骨科醫師帶來一連串的困擾，究其成因，以外傷引起者為多，尤以股骨幹骨折後所導致者占絕大部分。此外傷性膝關節僵直症之病變，不外乎是(1)股中間股之纖維化，與股直肌及股骨間發生粘連。(2)臏骨與股骨髁之間的粘連。(3)臏骨兩側腱膜纖維化。以及(4)股直肌之攣縮等導致膝關節之活動受到限制。手術治療的目的就是將彼此的粘連予以分解開。本院骨科自1984年4月至1986年4月，以Judet 股四頭肌成形術治療五位外傷性膝關節僵直症之病人，手術後以腰椎硬膜外麻醉協助下，立即施予持續性被動或主動之關節運動。經至少6個月以上之追蹤檢查，其結果良好。由以往文獻記載及本院之結果顯祓，手術之成功與否，除了取決於手術技術之外，術後之復健，尤其是持續性的關節運動占了極為重要的地位。

關鍵字

股四頭肌成形術；膝關節僵直症

並列摘要

Knee stiffness causes inconvenience in the patient’s life and difficulty in orthopedic treatment. The most common cause of knee stiffness is traumatic;i.e. the fracture of femoral shaft is particularly a major factor in the incidence. The pathogenesis of knee stiffness includes 1) fibrosis of the vastus intermedius muscle tying down the rectus femoris to the femur in the suprapatellar pouch and proximallyh, 2) adhesions between the patella and the femoral condyles, 3) fibrosis and shortening of the lateral expansions of the vasti asnd their adherence to the femoral condyles, 4) actual shortening of the rectus femoris muscle. All of them can limit the movements of the knee. The aim of surgical treatment is release of extra-articular and intra-articular adhesions or contractures which prevent useful flexion of the knee. Five cases were treated by Judet’s method at VGH-Taichung from Apr. 1984 to Apr. 1986. Post-operative rehabilitations including passive and active exercises were performed immediately under control of pain with epidural anesthesia. We have followed up these cases for at least 6 months with good results. Acoording to past literatures and our experiences, the success of operation depends on surgical skill and post-operative rehabilitations, with the latter being the most important factor.

並列關鍵字

Ouadricepsplasty ； Knee Stiffness

國際替代計量

以Judet股四頭肌成形術治療外傷性膝關節僵直症之初步探討—五病例報告

全文下載

主題瀏覽