后交叉韧带止点形态学测量及其重建骨道直径探讨  

Morphological Measurement of PCL Insertion and Optimized Tunnel Diameter for PCL Reconstruction

作　　者：陈连旭[1] 余家阔[1] 敖英芳[1] 王海军[1] 林霖[1] 

机构地区：[1]北京大学第三医院运动医学研究所,北京100191

出　　处：《中国运动医学杂志》2011年第10期911-915,947,共6页Chinese Journal of Sports Medicine

摘　　要：目的：在膝关节尸体标本上测量后交叉韧带（PCL）止点的形态大小,探讨重建PCL时骨道直径的选择。方法：解剖20具新鲜冷冻的膝关节尸体标本,标记PCL股骨和胫骨止点边界和前外束（AL）与后内束（PM）的分界。确定PCL、AL和PM纵轴并测量其长度,经过纵轴中点做其垂线,沿垂线测量其止点宽度,该宽度则为骨道最大直径。测量值用均数（第25百分位数~第75百分位数）表示。结果：PCL、AL和PM胫骨止点的纵轴宽度分别为10.64（9.52~11.51）mm,6.54（5.50~7.58）mm和5.85（5.37~6.56）mm。股骨止点纵轴宽度分别为11.01（10.27~12.04）mm,9.56（8.91~10.52）mm和9.47（8.85~10.28）mm。结论：根据解剖重建和胫骨、股骨骨道一致的原则,PCL单束重建的骨道直径可从9.5 mm到11.5 mm,均值10.5 mm;双束重建AL骨道直径可从6.5 mm到8.5 mm,均值7.5 mm;PL骨道直径可从6.0 mm到7.5 mm,均值6.5mm。Objective To measure the morphology of posterior cruciate ligament（PCL） insertion in human cadaver knee,and to search the optimized tunnel diameter for PCL reconstruction.Methods Twenty human cadaver knees were dissected,the periphery of PCL and boundary of anterolateral（AL）bundle and poteriomedial（PM）bundle in femoral and tibial attachment were marked,and the major axis and length of PCL,AL and PM bundles were confirmed and measured.The vertical line was drawn through the midpoint of the major axis,and the width of the footprint was measured along the vertical line to represent the maximum diameter of tunnel.The values were expressed as mean（from 25% to 75% percentile）.Results The width of PCL,and AL and PM bundles in tibial attachment was 10.64（9.52 ~ 11.51）mm,7.54（6.50 ~ 8.58）mm and 6.85（6.37 ~ 7.56）mm,respectively.and in femoral attachment was 11.01（10.27 ~ 12.04）mm,9.56（8.91 ~ 10.52）mm and 9.47（8.85 ~ 10.28）mm,respectively.Conclusion According to principle of anatomic PCL reconstruction and consistency of femoral and tibial tunnel,the diameter of tunnel should be determined by intraoperative measurement.The mean diameter of tunnel for single-bundle PCL reconstruction and for double-bundle PCL reconstruction was 10.5 mm（from 9.5 mm to 11.5 mm）and 6.5 mm（from 6.0 mm to 7.5 mm） respectively.

关 键 词：后交叉韧带 解剖重建 骨道 直径 

分 类 号：R687.3[医药卫生—骨科学]