摘要
目的:通过尸体标本研究前交叉韧带(ACL)股骨止点,进一步明确其解剖学特点,为双束重建ACL准确定位股骨止点提供临床解剖学数据。方法:对30例福尔马林处理的成人膝关节标本进行解剖研究。在屈膝60°时根据ACL纤维张力情况区分前内束和后外束,观察两束在膝关节屈伸过程中的张力变化特性,然后从股骨止点切断韧带,测量止点的相关数据。结果:在屈膝60°位ACL中松弛的纤维束最多。ACL在屈膝过程中沿矢状面发生旋转,其轴心大约位于股骨止点的近前角,接近over-the-top位置,该区域的纤维束在屈膝过程中始终处于紧张状态,具有良好的等长性。ACL股骨止点的长径与短径分别为19.32±2.42mm与10.52±2.24mm,前内束和后外束股骨止点的面积分别为69.37±20.2mm2和86.60±30.22mm2,前内束股骨止点的面积略小于后外束;两束中心点连线的距离为9.42±1.51mm,连线与股骨纵轴的夹角为26.90±8.56°;后外束中心点到over-the-top点连线的距离为11.8±1.60mm,连线与股骨纵轴的夹角为26.26±7.78°;后外束中心到股骨外髁软骨缘的最小距离为6.16±1.00mm;前内束股骨止点中心点位于10∶10±7′(右膝)或1∶49±5′(左膝);over-the-top点位于10∶45±8′(右膝)或1∶08±9′(左膝)。结论:前交叉韧带可被分为功能不同的前内束和后外束,前内束在膝关节的运动中始终保持紧张,具有较好的等长性,前内束止点前上部接近over-the-top区纤维是其旋转轴心,与前内束中心点的纤维相比等长性更好,是手术重建时的关键点。后外束只有在接近伸直和屈曲较大角度时紧张。后外束的定位缺乏解剖标记,本研究通过测量其中心点与前内束中心点、over-the-top点距离及到股骨外髁软骨缘最短距离确定后外束中心点位置,为双束重建ACL提供准确的骨道定位依据。
Objective To study the natural anterior cruciate ligament （ACL） attachment to the femur on body specimen treated with formalin in order to provide anatomic data for accurately performing double - bundie ACL reconstruction. Methods Thirty knee joints of the body specimen were anatomized. The natural ACL was divided into anteromedial bundle （AMB） and the posterolateral bundle （PLB） according to their tension at 60° knee flexion. The ACL was resected from the femoral attachment site. The biomechanical data of femoral attachment were measured. Results The majority of ACL fibers relaxed at 60° knee flexion, and the axial of the rotation were located at the proximal - anterior comer of ACL femoral attachment, nearby the over - the - top position, the fibers in that region were tensed and exhibited well isometric property throughout the whole range of motion. The diameter of the major axis and minor axis of ACL was 19.32 ± 2.42mm and 10.52 ± 2.24mm, respectively, and the area of AMB bundles and PLB bundles was 69.37 ± 20.2mm^2 and 86.60 ± 30.22mm^2, respectively. The distance between the attachment center of AMB and PLB was 9.42 ± 1.51mm, the angle formed by the long axis of the femoral shaft and the line through the attachment center of AMB and PLB was 26.90 ± 8.56°. The distance between the attachment center of PLB and over - the - top was 11.8 ± 1.60mm, and the angle formed by the long axis of femoral shaft and the line through the attachment center of PLB and over - the - top position was 26.26 ± 7.78°. The least distance from the attachment center of PLB to the cartilage border of lateral femoral condyle was 6.16 ± 1.00mm. The attachment center of the AMB was located at 10：10 ± 7＇（right knee） and 1：49 ± 5＇（left knee）, the over- the - top position was located at 10：45 ± 8＇（right knee） and 1：08 ± 9＇（left knee）. Conclusions ACL was divided into the anteromedial bundle and the posterolateral bundle functionally. The anteromedial bundle tensioned throughout th
出处
《中国运动医学杂志》
CAS
CSCD
北大核心
2007年第3期266-270,共5页
Chinese Journal of Sports Medicine
关键词
解剖学研究
前交叉韧带
股骨止点
双束重建
anatomic study, anterior cruciate ligament, femoral attachment, double bundle reconstruction
