急性膝蓋骨脱臼患者の全身性関節弛緩と膝蓋骨外方異常可動性について

Generalized Ligamentous Laxity and Lateral Patellar Hypermobility in Patients with Acute Patellar Dislocation

　急性膝蓋骨脱臼患者50人（以下脱臼群）と正常人50人の全身性関節弛緩と膝蓋骨外方異常可動性について調査した．全身性関節弛緩はCarter and Wilkinson変法で評価し，膝蓋骨外方異常可動性は，健側膝蓋骨で評価した．全身性関節弛緩は脱臼群の36％に陽性で，正常人の14％よりも2.6倍高率であった．一方，膝蓋骨外方異常可動性は脱臼群の58％に陽性で，正常人の6％よりも9.7倍高率であった．健側の膝蓋骨外方異常可動性は全身性関節弛緩よりも急性膝蓋骨脱臼と大きな関連性を持っていた．

　The purpose of this study was to investigate the association of generalized ligamentous laxity (GLL)and lateral patellar hypermobility in patients with an acute patellar dislocation (APD). A total of 50 APD patients were enrolled in this study. GLL was assessed using the modified Carter and Wilkinson method. In the APD group, lateral patellar mobility of the contralateral side was examined using the patellar glide test by Kolowich and the apprehension sign. As a control group, 50 normal individuals were examined. GLL was present in 36％ of the APD patients and 14％ of control individuals. Lateral patellar hypermobility was present in 58％ of the APD patients whereas it was noted in only 6％ of the normal individuals. This study showed that a correlation between lateral patellar hypermobility of the contralateral side and APD was much stronger than between GLL and APD. Therefore, contralateral patellar hypermobility in APD was more significant than GLL as one of the important predisposing factors.