膝关节前外侧韧带的解剖学和组织学研究

发布时间：2018-07-15 15:00

【摘要】：目的:观察我国成年人膝关节前外侧韧带(anterolateral ligament,ALL)的解剖学和组织学特点,以明确该韧带的存在性,为临床重建手术提供解剖学依据。方法:随机挑选10具成人膝关节标本进行解剖,观查前外侧韧带的股骨侧、胫骨侧和半月板侧附着点特点,解剖完毕后应用游标卡尺测量其长度、宽度、厚度等,最后留取3例标本做组织学染色。结果:(1)ALL起源于股骨外侧髁,与外侧副韧带股骨侧附着点相同或其远端偏前方,体部出现分叉形成两束分别止于前外侧胫骨平台和外侧半月板,ALL胫骨侧起点位于Gerdy结节与腓骨头连线中点,胫骨软骨缘以下,半月板止点位于外侧半月板前角与体部交接区。(2)ALL长度为38.89±4.67 mm;宽度在股骨、胫骨附着点呈扇形散开连于骨质,关节线处最窄,股骨、胫骨附着点和关节线处宽度分别为8.49±1.36 mm、8.15±1.38 mm、6.49±1.09 mm;厚度为1.33±0.38 mm;其胫骨附着点距Gerdy结节22.59±3.04 mm,距腓骨头21.15±2.78 mm,距胫骨软骨缘以下5.76±0.57 mm。(3)HE染色显示ALL是由平行排列的胶原纤维构成的致密结缔组织;S-100染色显示ALL含有感觉运动神经纤维。结论:ALL是一条独立于关节囊的韧带,起源于股骨外侧髁,体部分叉形成两束分别止于胫骨和外侧半月板。
[Abstract]:Objective: to observe the anatomical and histological features of the anterolateral ligament of the knee joint (anterolateral ligamentum) in adults in China, so as to clarify the existence of the ligament and provide anatomic basis for clinical reconstruction. Methods: ten adult knee joint specimens were randomly selected to observe the characteristics of the femoral side, tibial side and meniscus attachment point of the anterolateral ligament. The length, width and thickness of the knee joint were measured by Vernier caliper after dissection. Finally, 3 specimens were collected for histological staining. Results: (1) all originated from the lateral femoral condyle. Two bundles of bifurcation formed in the body were located at the midpoint of the line between Gerdy's tubercle and the fibula head, and below the tibial cartilage margin, respectively, from the anterolateral tibial plateau to the lateral meniscus of the lateral meniscus. (2) the length of all is 38.89 卤4.67 mm, the width of all is in femur, the tibia attachment point is fan-shaped, and the joint line is the narrowest. The width of tibial attachment point and articular line were 8.49 卤1.36 mm, 6.49 卤1.09 mm and 1.33 卤0.38 mm, respectively. The tibial attachment point was 22.59 卤3.04 mm from Gerdy's node, 21.15 卤2.78 mm from fibula head, 5.76 卤0.57 mm below tibial cartilage margin. (3) all was composed of parallel collagenous fibers arranged by HE. The S-100 staining of the dense connective tissue showed that all contained sensorimotor nerve fibers. Conclusion all is a ligament independent of the articular capsule, originated from the lateral femoral condyle, and the body forks form two bundles of tibia and lateral meniscus, respectively.
【作者单位】：青岛大学附属医院运动医学科;日照市人民医院关节外科;
【分类号】：R322.7;R687.4

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