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-  2017 

国人膝关节前外侧韧带的解剖学研究

DOI: doi:10.7507/1002-1892.201707042

Keywords: 膝关节, 前外侧韧带, 外侧副韧带, 解剖学

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Abstract:

目的 解剖研究国人膝关节前外侧韧带(anterolateral ligament,ALL),探讨 ALL 结构特征,为临床上 ALL 损伤的诊治,特别是 ALL 重建手术的开展提供参考。 方法 选用成年尸体膝关节标本 16 具,男、女各 8 具,左、右膝各 8 具;供体年龄 57~84 岁,平均 73.5 岁。根据标准入路进行解剖,并对 ALL 进行定性和定量的描述。 结果 16 具标本中 12 具可见 ALL,出现率为 75.0%。它起自股骨外上髁,起点位于外侧副韧带(lateral collateral ligament,LCL)的起点近端后方,其走行越过 LCL 表面或与之并行,韧带中段与外侧半月板体部边缘紧密相连,止点位于 Gerdy 结节和腓骨头之间,止点中心与 Gerdy 结节中心以及腓骨头最外侧缘的距离分别为(23.9±3.3)、(23.8±4.0)mm。膝关节中立位屈曲 0° 和 60° 时 ALL 长度分别为(44.8±5.1)、(47.8±5.5) mm,比较差异无统计学意义(t=14.071,P=0.000),在膝关节屈曲 60° 合并内旋时 ALL 较紧张。根据男女进行分组比较,屈曲 0° 和 60° 时男性 ALL 长度均显著大于女性(t=2.920,P=0.015;t=2.806,P=0.019);其余测量指标比较,差异无统计学意义(P>0.05)。 结论 ALL 是一条位于膝关节前外侧的独立非等长韧带结构,其长度存在性别差异。ALL 在维持膝关节旋转稳定性方面发挥一定作用,临床上应引起足够重视

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