膝关节前外侧韧带的解剖学和组织学研究  

Anatomical and Histological Study of Anterolateral Ligament of Knee

作　　者：朱永乐[1] 戚超[1] 李常辉[2] 赵夏[1] 于腾波[1] 

机构地区：[1]青岛大学附属医院运动医学科,青岛266000 [2]日照市人民医院关节外科

出　　处：《中国运动医学杂志》2017年第6期472-478,共7页Chinese Journal of Sports Medicine

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。Objective To observe the anatomical and histological features of anterolateral ligament（ALL）in the knee of Chinese adults,so as to identify the existence of ALL and provide an anatomicalfoundation for clinical reconstruction. Methods Ten adult knee specimens were randomly selected to bedissected,and the femoral,tibial and meniscus attachment points of the ALL were observed. The length,width and thickness were measured using the vernier caliper after the dissection. Three specimenswere subjected to histological staining in the end. Results（1）ALL originated from the lateral femoralcondyle-the same point of the lateral collateral ligament femoral side or the distal-anterior side,withits body divided into two branches,located in the tibia and the lateral meniscus respectively. The starting point of tibial side ALL was located at the mid-point of Gerdy＇s tubercle to fibula head,below tibial cartilage edge,with the meniscus point located in the lateral meniscus anterior horn and body junction area.（2） The average length of ALL is 38.89 ± 4.67 mm. The width in the femur,tibial attachment point was fan-shaped spread connected with sclerotin,being the narrowest at the joint line. Thewidth at the femur,tibial attachment point and the joint line was 8.49 ± 1.36 mm,8.15 ± 1.38 mmand 6.49 ± 1.09 mm respectively,with the thickness of 1.33 ± 0.38 mm. The distance from tibia attachment points to the Gerdy＇s tubercle,fibular head and tibia cartilage margin was 22.59 ± 3.04 mm,21.15 ± 2.78 mm and 5.76 ± 0.57 mm respectively.（3） HE staining showed that ALL was dense con-nective tissue consisting of parallel arranged collagen fibers,while S-100 staining indicated that ALLcontained sensory motor nerve fibers. Conclusion ALL is independent of the joint capsule and originates from the femoral lateral condyle. Its body is divided into two branches,located in the tibia and the lateral meniscus respectively.

关 键 词：前外侧韧带 解剖 组织学 膝关节稳定 SEGOND骨折 

分 类 号：R322.7[医药卫生—人体解剖和组织胚胎学] R687.4[医药卫生—基础医学]