电邮这篇文章 儿童髌骨不稳定的临床与MRI影像学表现
- 作者: Lukyanov S.A.1, Zorin V.I.1,2
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隶属关系:
- H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
- North-Western State Medical University named after I.I. Mechnikov
- 期: 卷 13, 编号 2 (2025)
- 页面: 145-153
- 栏目: Clinical studies
- URL: https://journal-vniispk.ru/turner/article/view/312533
- DOI: https://doi.org/10.17816/PTORS678328
- EDN: https://elibrary.ru/ESAPBY
- ID: 312533
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详细
论证。髌骨不稳定是指髌骨相对于股骨滑车沟发生反复性脱位或半脱位的状态。该病是儿童膝关节最常见的疾病之一。骨性结构与软组织结构共同作为髌骨的稳定器，任一结构的改变均可能成为导致不稳定的原因。对于髌骨不稳定患儿，磁共振成像所提供的髌股关节区域骨软骨及软组织结构状态的信息具有重要的实用价值，且可与临床表现进行对照分析。
目的：评估儿童髌骨不稳定患者髌股关节区磁共振成像的主要表现及其临床特征。
材料与方法。分析髌骨不稳定患者与前交叉韧带损伤患者的流行病学资料、临床数据及磁共振成像结果。共有52例主组患儿和44例前交叉韧带损伤的对照组患儿符合纳入标准。年龄分布无统计学显著差异。
结果。在Wiberg髌骨类型、脱位预感和髌骨过度活动度方面，各组之间存在显著差异。在患者的股骨滑车外侧倾斜角度、滑车窝深度以及脱位预感和髌骨过度活动度等临床表现方面也观察到统计学显著差异（p < 0.001）。
结论。股骨滑车发育不良是促使儿童患者出现髌骨不稳定的重要因素。本研究证实，表征股骨滑车发育不良的指标在儿童髌骨不稳定中具有统计学显著差异，且该因素与临床表现之间存在相关性。
作者简介
Sergey A. Lukyanov
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
编辑信件的主要联系方式.
Email: Sergey.lukyanov95@yandex.ru
ORCID iD: 0000-0002-8278-7032
SPIN 代码: 3684-5167
MD, PhD, Cand. Sci. (Medicine)
俄罗斯联邦, Saint PetersburgVyacheslav I. Zorin
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery; North-Western State Medical University named after I.I. Mechnikov
Email: zoringlu@yandex.ru
ORCID iD: 0000-0002-9712-5509
SPIN 代码: 4651-8232
MD, PhD, Cand. Sci. (Medicine), Assistant Professor
俄罗斯联邦, Saint Petersburg; Saint Petersburg参考
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Fig. 1. Lateral trochlear inclination on magnetic resonance imaging in a 15-year-old female patient with patellar instability (1.2°) (a) and in a 17-year-old female patient with anterior cruciate ligament injury (21°) (b). A, line tangent to the lateral facet; B, line tangent to the posterior condylar line.
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Fig. 2. Trochlear facet asymmetry index on magnetic resonance imaging: (a) 16-year-old female patient with patellar instability (33%) and (b) 17-year-old female patient with anterior cruciate ligament injury (75%). M, medial facet length; L, lateral facet length.
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Fig. 3. Trochlear groove depth measurement on magnetic resonance imaging in a 16-year-old female with patellar instability: A, maximal anteroposterior distance between the femoral condyles and lateral facet; B, maximal anteroposterior distance between the femoral condyles and deepest point of the trochlear groove; and C, maximal anteroposterior distance between the femoral condyles and medial facet.
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Fig. 4. Patellotrochlear index on magnetic resonance imaging: a, 16-year-old female with patellar instability. Patellotrochlear index value: 11.4%; b, 15-year-old male with anterior cruciate ligament injury. Patellotrochlear index value: 39.1%. A, length of the trochlear articular surface in contact with the patellar articular surface; B, length of the patellar articular surface (patellar height).
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