内侧髌股韧带重建术中骨骺闭合与否对股骨侧定位方法选择的影响

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Abstract Objective To investigate the influence of epiphyseal closure on the choice of lateral femoral positioning method during medial patellofemoral ligament reconstruction surgery.Methods A total of 88 patients with recurrent patellar dislocation admitted to the Department of Sports Trauma and Arthroscopy in the First Affiliated Hospital of Anhui Medical University from September 2018 to May 2022 were selected.There were 48 cases in the epiphysis unclosed group，including 20 males and 28 females.The patients aged 12~15 years，with an average of (12.72±1.62) years.There were 40 patients with closed epiphysis，including 14 males and 26 females.The patients age ranged from 16 to 24 years，with an average age of (19.25±1.58) years.The point of Schottle was marked as point S and the midpoint of the medial tuberosity and medial femoral condyle was marked as point A.The point of Fujino's position was marked as point F.The distance between SA and SF was measured separately.The clinical efficacy of these two positioning methods in the treatment of patellar dislocation in adolescents was evaluated by comparing the Kujala score and Lysholm score at the last followup of adolescent patients.Results Compared to patients with closed epiphyses，there was a significant difference (p < 0.05) in the distance between the lateral femoral positioning point (point A) and point S determined by the anatomical positioning method commonly used in clinical practice：The midpoint positioning method，and the anatomical positioning method represented by the medial tuberosityassisted positioning method，which was used in patients with unclosed epiphyses for “isometric”.The anatomical localization method，represented by the nodal-assisted localization method，was more effective in patients with unclosed epiphyses.It also has a significantly better clinical outcome at post-operative patient follow-up than the former.Conclusion Compared to the lateral femoral positioning method in adult MPFL reconstruction，the midpoint positioning method is not optimal in patients with unclosed epiphyses，while the adductor node assisted positioning method is more suitable for children or adolescents with unclosed epiphyses.

Key words： distal femoral epiphysis adolescent patellar dislocation medial patellofemoral ligament reconstruction femoral isometrical point

Corresponding Authors: Xu Bin

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	Jia Yichen
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	Guo Ruipeng

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Jia Yichen,Xu Bin,Guo Ruipeng. Influence of Epiphyseal Closure on the Choice of Lateral Femoral Positioning Method During Medial Patellofemoral Ligament Reconstruction[J]. sygkzz, 2023, 29(4): 315-.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2023/V29/I4/315

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