大收肌腱转位重建内侧髌股韧带的应用解剖  

Applied anatomic study on reconstructing the medial patellofemoral ligament by using the adductor magnus tendon

作　　者：张亮[1] 高建明[2] 项杨[2] 陈伟南[2] 宗序华[2] 王亚东[2] 

机构地区：[1]安徽医科大学无锡临床学院,江苏无锡214000 [2]中国人民解放军第101医院骨科,江苏无锡214000

出　　处：《中国临床解剖学杂志》2017年第3期241-244,共4页Chinese Journal of Clinical Anatomy

摘　　要：目的评估大收肌腱转位重建内侧髌股韧带治疗髌骨脱位的术式可行性及可能的风险,探讨转位肌腱固定方法。方法解剖观察30侧尸体标本的大收肌腱及内侧髌股韧带形态及其周围血管神经等毗邻关系;测量收肌结节至内侧髌股韧带股骨止点距离、收肌结节至大收肌腱移行部距离;并在尸体标本上模拟手术。结果大收肌腱长度(收肌结节至收肌裂孔距离)为(105±14)mm(77~129 mm),内侧髌股韧带轴长长度为(46±6)mm(33~57 mm),收肌结节至内侧髌股韧带股骨止点距离为(9±2)mm(6~13 mm),收肌结节至大收肌腱移行部距离为(124±11)mm(102~144 mm)。结论长约55 mm的大收肌腱通过转位固定于髌骨内侧缘重建内侧髌股韧带可行,大收肌腱作为重建内侧髌股韧带的供体是一个良好的选择。Objective To evaluate the surgical feasibility and possible risks of reconstructing the medial patellofemoral ligament（MPFL）using the adductor magnus tendon,and explore the methods of the fixation techniques. Methods Anatomical characteristics of adductor magnustendon, the medial patellofemoral ligament morphology, and peripheral vascular nerve adjacent relationship were observed on 30 cadaveric knees. The distance from adductor tubercle to the MPFL femoral attachment,and the distance from adductor tubercle to transitional part were measured. Surgical simulation was operated on the cadavers. Results Length of adductor magnus tendon （distance from the adductor tubercle to the adductor hiatus） was （105 ± 14）mm（77~129 mm）,length of the medial patellofemoral ligament was （46 ± 6） mm（33~57 mm）,the distance from the adductor tubercle to the MPFL femoral insertion was （9±2） mm（6~13 mm）,and the distance from the adductor tubercle to transitional part was （124±11）mm（102~144 mm）. Conclusions Fixation of graft with a length of 55 mm in the medial border of the patella for the reconstruction of the MPFL is feasible. Considering the anatomical risk on the operation,the adductor magnus tendon as a reconstruction graft of the MPFL is a good choice.

关 键 词：髌骨脱位 大收肌腱 内侧髌股韧带 重建 

分 类 号：R322.73[医药卫生—人体解剖和组织胚胎学]