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梁兴森,余正红,王宗帅,李鉴轶,李义凯.股四头肌肌力与髌股关节稳定性关系的研究[J].中国康复医学杂志,2008,23(12):1064~1066
股四头肌肌力与髌股关节稳定性关系的研究    点此下载全文
梁兴森  余正红  王宗帅  李鉴轶  李义凯
南方医科大学中医药学院骨伤推拿教研室 广州,510515
基金项目:国家863项目 (2006AA01Z310);国家自然科学基金(30600302)
DOI:
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摘要:
      目的:了解组成股四头肌的4块肌在维持髌骨稳定性中的作用,为临床治疗髌股关节不稳提供理论依据。 方法:对6例新鲜膝关节标本,在不同屈曲度下,分4种工况进行加载分别模拟组成股四头肌的4块肌在生理及不同病理状态下的肌力。对髌骨施加外侧方移位载荷,记录使髌骨向外移位1cm的载荷。结果:生理状态下,在膝关节屈曲过程中,20°时使髌骨向外侧半脱位的载荷最小(61±13N),约为屈曲90°时的1/3;在松解股内侧肌后,屈膝10°—30°半脱位载荷明显减小(P<0.05),进一步松解股外侧肌导致整个屈膝过程中半脱位载荷均明显减小(P<0.05)。结论:整个股四头肌在髌骨外侧半脱位的预防、治疗及康复过程中具有重要作用,手术治疗不宜破坏股外侧肌,康复尤其应重视股内侧肌肌力的恢复。
关键词:髌股关节  股四头肌  髌骨半脱位
Exploration of relation between muscle force of the quadriceps femoris and patellofemoral stabilization    Download Fulltext
Department of Traditional Chinese Orthopedics and Traumatology, School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515
Fund Project:
Abstract:
      Objective:To understand the contribution of the 4 muscles of the quadriceps femoris, and to provide a theoretical basis for clinical treatment of instability of the patellofemoral joint.Method:Six fresh human cadaver knees were flexed at different angles, loading the 4 muscles to simulate 4 operating conditions of physiology and pathologic situation and then loading the patella to deviate it 1.0cm from normal position laterally, and measured the loads. Result: In physiologic condition, at 20°in the process of the knee flexing, the loads which subluxated the patella was smallest(61±13N), about one-third of 90°. Slackened the vastus medialis, the loads decreased obviously when flexing 10°—30°, and had significant difference(P<0.05). Slackened vastus lateralis in addition, the loads decrease obviously in the whole flexing process, and it had significant difference(P<0.05). Conclusion: The quadriceps femoris have significant function in the management of patella subluxation, should not be broken when operation. The strength of medial vastus muscle should be pay more attentions in rehabilitation.
Keywords:patellofemoral joint  quadriceps femoris  patellar subluxation
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