内侧髌股韧带重建术中大收肌腱股骨远端附着点的相关解剖学研究及其临床意义  

Anatomical study of the distal femoral attachment site of the adductor magnus tendon in medial patellofemoral ligament reconstruction and its clinical significance

作　　者：徐飞虎 张克远[1] Xu Feihu;Zhang Keyuan(Department of Sports Medicine,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学第一附属医院运动医学科,乌鲁木齐830000

出　　处：《中华解剖与临床杂志》2024年第7期451-455,共5页Chinese Journal of Anatomy and Clinics

摘　　要：目的探讨大收肌腱股骨远端附着点与Schöttle’s点的位置关系,为大收肌腱在内侧髌股韧带(MPFL)重建手术中的应用提供相关解剖学证据。方法解剖8具成人尸体膝关节,定位并标记大收肌腱股骨远端附着点,模拟术中X线透视制备标准膝关节侧位X线片。使用等比例法于X线片上测量大收肌腱股骨远端附着点与Schöttle’s点的直线距离,评估两点基于X轴上的前后距离,同时使用卡尺在标本上测量以开口取腱器分离获取的大收肌腱的长度(即大收肌腱股骨远端附着点与其腱腹联合处断端的间距)。结果标准膝关节X线侧位片测量:大收肌腱股骨远端附着点到Schöttle’s点的直线距离为7.0~16.0(12.3±3.0)mm,两点之间基于X轴上的前后距离为0.2~5.5(2.6±1.7)mm。标本卡尺测量:大收肌腱长度为115~158(136.1±12.9)mm。结论虽然大收肌腱的长度足以满足MPFL重建的需要,但其股骨远端附着点与Schöttle’s点间的距离远大于5 mm,难以实现解剖重建,因此对于大收肌腱的使用应保持谨慎态度。ObjectiveThis study aimed to explore the positional relationship between the distal femoral attachment of the adductor magnus tendon and Schöttle's point to provide relevant anatomical evidence for the application of the adductor magnus tendon in medial patellofemoral ligament(MPFL)reconstruction surgery.MethodsEight adult cadaveric knee joints were dissected to identify and mark the distal femoral attachment site of the adductor magnus tendon.Standard lateral radiographs of the knee were obtained using simulated intraoperative X-ray fluoroscopy.The linear distance between the distal femoral attachment of the adductor magnus tendon and Schöttle's point was measured on the radiographs through proportional scaling.The anterior-posterior distance between the two points relative to the X-axis was assessed.The length of the adductor magnus tendon was measured on the specimen by using a caliper,following separation with a tendon harvester.The length corresponded to the distance from the distal femoral attachment site to the junction of the tendon and its muscle belly.ResultsMeasurements on standard lateral radiographs of the knee revealed that the linear distance from the distal femoral attachment of the adductor magnus tendon to Schöttle's point ranged from 7.0-16.0(12.3±3.0)mm.The anterior-posterior distance between the two points measured along the X-axis ranged from 0.2-5.5(2.6±1.7)mm.Caliper measurements on the specimens yielded adductor magnus tendon lengths ranging from 115-158(136.1±12.9)mm.ConclusionAlthough the length of the adductor magnus tendon is sufficient to meet the requirements for MPFL reconstruction,the distance between its distal femoral attachment and Schöttle's point is significantly greater than 5 mm,which makes anatomical reconstruction challenging.Therefore,a cautious approach should be adopted regarding the use of the adductor magnus tendon for such procedures.

关 键 词：髌骨脱位 大收肌腱 股骨隧道位置 内侧髌股韧带重建术 解剖学研究 

分 类 号：R687.4[医药卫生—骨科学]