前交叉韧带解剖重建股骨隧道与外侧副韧带解剖重建股骨隧道的关系

发布时间：2018-02-21 13:08

本文关键词： 膝关节前交叉韧带外侧副韧带隧道重建应用解剖学人　出处：《解剖学报》2017年01期 　论文类型：期刊论文

【摘要】：目的探讨前交叉韧带(ACL)单束解剖重建股骨隧道与外侧副韧带(LCL)重建股骨隧道的关系,以期为临床中ACL解剖重建提供解剖学数据,便于临床实际操作中避免2个股骨隧道相互干扰,为ACL和LCL一期解剖重建提供依据。方法采用30例成人尸体膝部标本,保留膝关节上下至少20cm,排除关节明显退变、畸形及关节损伤。男性16例,女性14例,年龄在23~66岁,平均年龄38.7岁。屈膝120°经前内辅助入路(AMP)钻取股骨隧道。在股骨外髁外侧面寻找后外侧角(PLC)结构,钝性分离LCL,并钻取LCL隧道。标本进行CT扫描,在CT片上观察隧道碰撞数,并计算两个隧道的最短距离。结果在LCL股骨隧道深度为25mm时,其与ACL股骨隧道最短距离为(3.9±2.4)mm;在LCL股骨隧道深度为30mm时,其与ACL股骨隧道最短距离为(2.7±1.9)mm。在ACL股骨隧道深度为25mm时,其与LCL股骨隧道的最短距离为(4.4±2.6)mm;在ACL股骨隧道深度为30mm时,其与LCL股骨隧道的最短距离为(3.2±2.1)mm。在30例标本中,共发现6例隧道碰撞,碰撞的几率高达20%。结论我们发现两者隧道发生碰撞的几率高,临床一期解剖重建时,术前应做个体化准备,规划好LCL重建所需股骨隧道的长度和隧道直径,从而规避与ACL股骨隧道的碰撞。
[Abstract]:Objective to investigate the relationship between single bundle anatomical reconstruction of femoral tunnel with anterior cruciate ligament (ACL) and lateral collateral ligament (LCL) in order to provide anatomical data for clinical ACL anatomical reconstruction. In order to avoid interference between two femoral tunnels in clinical practice and provide basis for primary anatomical reconstruction of ACL and LCL, 30 adult cadaveric knee specimens were used to preserve the upper and lower knee joints at least 20 cm to exclude obvious degeneration of the joints. Malformation and joint injury. Male 16 cases, female 14 cases, age 23 to 66 years old, mean age 38.7 years. 120 掳flexion through anterior internal auxiliary approach (AMP) to drill the femoral tunnel. The lateral posterior lateral horn (PLC) structure was located on the lateral side of the lateral femoral condyle. The LCL tunnel was obtuse and drilled. The CT scan was performed on the specimen, the number of tunnel collisions was observed on CT film, and the shortest distance between the two tunnels was calculated. Results when the depth of the LCL femur tunnel was 25mm, The shortest distance to ACL femur tunnel is 3.9 卤2.4 mm, the shortest distance to ACL femur tunnel is 2.7 卤1.9 mm when the depth of LCL femoral tunnel is 30 mm, the shortest distance to LCL femoral tunnel is 4.4 卤2.6 mm when ACL femoral tunnel depth is 25 mm, and ACL femoral tunnel depth is 30 mm. The shortest distance from the tunnel to the femoral tunnel of LCL is 3.2 卤2.1 mm. in 30 specimens, 6 cases were found to collide, and the probability of collision was as high as 20%. Conclusion the probability of collision between the two tunnels is high. Individualized preparation should be made before operation and the length and diameter of the femoral tunnel needed for reconstruction of LCL should be planned to avoid the collision with the femoral tunnel of ACL.
【作者单位】：温州医科大学附属第三医院骨科;
【基金】：浙江省医药卫生科技项目(2014KY260)
【分类号】：R687.4;R322.7

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