前交叉韧带重建胫骨侧止点定位的应用解剖学研究

发布时间：2018-05-09 09:39

本文选题：前交叉韧带 + 胫骨侧止点　；参考：《南京医科大学学报(自然科学版)》2017年03期

【摘要】：目的:研究前交叉韧带(anterior cruciate ligament,ACL)胫骨止点的解剖位置,为重建ACL手术的临床应用提供解剖支持。方法:解剖40例膝关节尸体标本,应用高清数码相机拍摄照片后导入计算机,根据股骨髁间窝顶延长线和胫骨平台交界点标示出"撞击区"。在"无撞击区"内分别于ACL胫骨止点区、前内侧束(anteromedial bundle,AMB)止点区、后外侧束(posterolateral bundle,PLB)止点区填入合适大小圆形,分别测量其中心点与过顶脊及胫骨平台内侧髁间棘外侧面之间的距离。结果:采用单束重建ACL时,胫骨侧隧道中心点距过顶脊和胫骨内侧髁间嵴边缘分别为(16.95±0.97)mm和(5.99±0.30)mm。采用双束重建ACL时,AMB隧道中心点距两者的距离分别为(17.34±0.30)mm和(5.53±0.25)mm;PLB隧道中心点距两者的距离分别为(10.35±0.31)mm和(4.19±0.12)mm。结论:本研究阐明了ACL解剖重建中胫骨止点定位的解剖学特点,过顶脊和胫骨平台内侧髁间嵴外侧面可以作为手术定位的标准参考点。
[Abstract]:Objective: to study the anatomical location of tibial stop of anterior cruciate ligamentum anterior cruciate ligament (ACL) and to provide anatomic support for the clinical application of ACL reconstruction. Methods: 40 cadaveric specimens of knee joint were dissected, and the images were taken by high-definition digital camera and then imported into computer. According to the extension line of femoral intercondylar fossa and the junction point of tibial plateau, the "impingement zone" was marked. In the "impingement free zone", the ACL tibial insertion area, the anterior medial bundle anterior cordial bundling area and the posterolateral lateral bundling area were filled in respectively. The distance between the center point and the lateral side of the medial intercondylar spine of the tibial plateau and the medial tibial plateau was measured, and the distance between the center point and the lateral side of the condylar spine was measured. Results: when ACL was reconstructed by single bundle, the distance between the center of tibial side tunnel and the edge of medial tibial intercondylar ridge was 16.95 卤0.97)mm and 5.99 卤0.30 mm. respectively. The distance between the center point of AMB tunnel and the center point of the tunnel is 17.34 卤0.30)mm and 5.53 卤0.25mm respectively, and the distance is 10.35 卤0.31)mm and 4.19 卤0.12mmm. respectively. Conclusion: in this study, the anatomical characteristics of tibial insertion location in ACL anatomical reconstruction were clarified, and the lateral side of the medial intercondylar ridge of the tibial plateau and the transparietal ridge could be used as the standard reference points for surgical localization.
【作者单位】：苏州市独墅湖医院(苏州大学医学中心)骨科;南京医科大学附属无锡人民医院骨科;南通大学医学院人体解剖学系;
【分类号】：R687.4;R322.7

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