成人胫骨平台后内侧“H”点的应用解剖学研究  

Applied Anatomical Study of“H”Point on the Posterolateral Tibial Plateau of Adults

作　　者：朱超华[1] 李佳 刘国彬[1] 董威[1] 贾国兴 黄野[2] Zhu Chaohua;Li Jia;Liu Guobin;Dong Wei;Jia Guoxing;Huang Ye(Department of Orthopedics,The First Hospital of Hebei Medical University,Shijiazhuang 050031,China;Department of Orthopedics,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]河北医科大学第一医院骨科,河北石家庄050031 [2]北京积水潭医院矫形骨科,北京100035

出　　处：《实用骨科杂志》2022年第3期220-222,228,共4页Journal of Practical Orthopaedics

摘　　要：目的讨论成人膝关节“H”点的解剖学特征,丰富膝关节周围解剖内容,且为3D打印截骨导板提供理论依据。方法由河北医科大学解剖教研室提供5具成人膝关节标本,年龄57~73岁,平均(64.6±5.5)岁,其中男性4具,女性1具。以膝关节前内侧为解剖中心逐层解剖,用定位针进行解剖标记,观察并记录“H”点的形态及周围软组织走行,测量并记录“H”点相关解剖参数,进行定性及定量描述。结果5具膝关节标本均发现“H”点存在,位于胫骨后内侧,接近胫骨内侧嵴位置,该点距离关节面约1.53 cm;“H”点距离标准胫骨高位截骨(high tibial osteotomy,HTO)手术切口的垂直距离为3.53 cm;“H”点呈不规则椭圆形,其横径平均为(0.62±0.07)cm。结论“H”点为半膜肌肌腱止点,位于胫骨平台下方约1.53 cm处,“H”点的存在为3D打印HTO截骨导板提供了稳定有效的解剖学基础,在数字化保膝治疗中能发挥一定作用。Objective To discuss the anatomical characteristics of “H” point of adult knee joints, so as to enrich the anatomical content around the knee joint and provide theoretical basis for 3 D printing osteotomy guide plate.Methods Five adult knee specimens were provided by the department of anatomy, of Hebei medical university.The average age was(64.6±5.5).There were 4 males and 1 female.The anteromedial part of the knee joint was dissected layer by layer, and anatomic marks were made with positioning needle.The shape of “H” point and the course of surrounding soft tissue were observed and recorded.The relevant anatomical parameters of “H” point were measured and recorded for qualitative and quantitative description.Results The “H” point was found in all the 5 knee specimens, which was located in the posteromedial tibia, close to the medial tibial ridge, and was about 1.53 cm from the articular surface.The vertical distance between the “H” point and the standard HTO incision was 3.53 cm.The “H” point was an irregular ellipse with an average transverse diameter of(0.62±0.07)cm.Conclusion The “H” point is the insertion point of semimembranosus muscle tendon, which is about 1.53 cm below the tibial plateau.The existence of “H” point provides a stable and effective anatomical basis for 3 D printing HTO osteotomy guide plate, and plays a certain role in digital knee preservation treatment.

关 键 词：半膜肌 胫骨高位截骨术 3D打印 截骨导板 

分 类 号：R684.3[医药卫生—骨科学]