膝关节内外侧韧带结构股骨止点的骨性定位研究

发布时间：2018-02-21 06:25

本文关键词： 股骨内外侧髁骨性定位韧带重建解剖　出处：《中国运动医学杂志》2015年02期 　论文类型：期刊论文

【摘要】：目的:研究股骨髁内、外侧面表面特征,探索内侧副韧带、内侧髌股韧带、外侧副韧带、乆肌腱重建时股骨定位参照点。方法:选取2013年7月~2014年7月国内正常成人志愿者男58膝、女58膝,进行320 CT容积扫描股骨远端三维重建,分别在股骨内上髁、外上髁表面画前后标记线及上下标记线,测量内、外上髁最高点相对远端软骨缘平面高度,距离前后、上下标记线的长度。同时对13例新鲜冷冻成年膝关节标本标记行320CT扫描重建,测量骨性最高点与韧带附着点中心的距离与方位。结果:股骨外上髁最高点与远端软骨缘相对高度为男5.79±1.38 mm、女6.11±1.84 mm,股骨内上髁最高点与远端相对高度为男6.91±1.62 mm、女6.82±1.43 mm。股骨外上髁最高点到后髁的相对距离占前后比为男(33.8±3.0)%、女(32.8±4.6)%,到远端的距离占上下比为男(59.5±4.1)%、女(60.8±3.7)%。股骨内上髁最高点到后髁的相对距离占前后比为男(44.7±8.1)%、女(48.5±6.1)%,到远端的距离占上下比为男(63.9±7.8)%、女(64.8±7.8)%。外侧副韧带位于股骨外上髁最高点远后方(50.5±5.4)°、2.96±0.36 mm,乆肌腱位于远后方(38.07±2.57)°、10.52±0.86 mm。内侧副韧带位于股骨内上髁最高点远后方(37.6±2.9)°、4.93±0.71 mm,内侧髌股韧带位于近后方(37.21±1.16)°、12.79±1.68 mm。结论:股骨内、外侧髁侧面上均有位置、高度相对恒定的骨性最高点,可作为四条韧带重建时股骨定位参照点,本实验的数据可以为临床提供参考。
[Abstract]:Objective: to study the surface features of medial and lateral femoral condyle and explore medial collateral ligament, medial patellofemoral ligament and lateral collateral ligament. Methods: from July 2013 to July 2014, 58 knees of male and 58 knees of female were selected for 3D reconstruction of distal femur with 320 CT volumetric scanning, respectively, in the medial epicondyle of femur. The surface of the outer epicondyle was marked and marked up and down. The height of the highest point of the outer epicondyle relative to the level of the distal margin of the cartilage, the distance before and after, was measured. The length of upper and lower labeling lines. At the same time, 13 fresh frozen adult knee joint specimens were reconstructed by 320 CT scan. The distance and orientation between the highest point of bone and the center of attachment point of ligaments were measured. Results: the relative height between the highest point of external epicondyle of femur and distal margin of cartilage was 5.79 卤1.38 mm for male, 6.11 卤1.84 mm for female, 6.91 卤1.62 mm for male and 6.91 卤1.62 mm for female. 6.82 卤1.43 mm. the relative distance from the highest point of the external epicondyle to the posterior condyle was 33.8 卤3.0 for the male, 32.8 卤4.6 for the female, 59.5 卤4.1 for the distal end, 60.8 卤3.7 for the female. The relative distance from the highest point of the medial epicondyle to the posterior condyle was 44.7 卤8.1, 48.5 卤6.1, and 48.5 卤6.1 to the distal end of the femoral condyle. The distance is 63.9 卤7.8 mm for males and 64.8 卤7.8 mm for females. The lateral collateral ligament is 50.5 卤5.4 掳卤0.36 mm at the highest point of the external epicondyle of femur, and the tendons are 38.07 卤2.57 掳and 10.52 卤0.86 mm respectively. The medial collateral ligament is located in 37.6 卤2.9 掳and the medial patellofemoral ligament is 37.6 卤2.9 掳and 4.93 卤0.71 mm respectively, and the medial patellofemoral ligament is located in the distal and posterior part of the medial epicondyle of femur, and the medial patellofemoral ligament is located in the medial patellofemoral ligament. The proximal posterior area was 37.21 卤1.16 掳and 12.79 卤1.68 m.Conclusion: intrafemur, The lateral condyle has a position on the lateral side and the highest point of bone with a relatively constant height can be used as a reference point for the femur position during the reconstruction of the four ligaments. The data of this experiment can be used as a reference for clinical practice.
【作者单位】：河北北方学院;中国人民解放军第309医院;
【分类号】：R874

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