膝关节交叉韧带和侧副韧带的断面解剖学研究及其意义

目的研究膝关节交叉韧带和侧副韧带的断面形态特征和变化规律,为诊断膝部韧带病变提供更为详尽的形态学资料。方法利用27例正常成人膝关节标本制作连续断面,其中矢状断面9例,冠状断面12例,横断面6例。通过横、矢、冠状断面标本,观测膝关节韧带的断面形态特征及定量测量。结果矢状面上测量前、后交叉韧带长度分别为(29.66±4.21)mm、(40.26±6.81)mm,厚度分别为(10.03±1.97)mm、(11.24±3.50)mm。冠状面上前、后交叉韧带长径分别为(15.18±3.25)mm、(18.79±3.35)mm,短径分别为(6.37±1.32)mm、(8.03±1.46)mm;胫、腓侧副韧带长度分别为(102.85±19.64)mm、(45.52±14.91)mm,厚度分别为(2.63±0.72)mm、(3.43±1.04)mm。髁间隆起的横断面上胫、腓侧副韧带长径分别为(21.98±11.95)mm、(5.25±1.93)mm,短径分别为(2.03±0.59)mm、(2.87±0.64)mm。结论 (1)观测交叉韧带最好的断面是膝关节正中矢状面,其次是正中旁开1个矢状断面。除厚度外,在矢状面上前后交叉韧带长度、股、胫骨附着区宽度均有明显差异。(2)胫、腓侧副韧带在连续的冠状断面及横断面上均可显示,以冠状断面配合横断面相对为佳。

Sectional anatomy and clinical significance of the cruciate ligaments and collateral ligaments of knee joint

Objective　To provide morphological basis for the imaging diagnosis of the ligament diseases of knee joint.　Methods　A total of 27 sides of adult genicular specimens were used in this study. 6 serial transverse，9 sagittal，and 12 coronal sections of 5mm in thickness were made respectively. The features and parameters of different ligaments on three-dimensional sections was observed and measured.　Results　On sagittal plane, the lengths of anterior and posterior cruciate ligaments were (29.66±4.21)mm and (40.26±6.81)mm, the thickness of anterior and posterior cruciate ligament were (10.03±1.97)mm and (11.24±3.50)mm respectively. On coronal plane, the longitudinal diameters of the two ligaments were (15.18±3.25)mm and (18.79±3.35)mm, and the transverse diameters (6.37±1.32)mm and (8.03±1.46)mm respectively. The lengths of tibial and fibular collateral ligament were (102.85±19.64)mm and (45.52±14.91)mm, and the thickness of them (2.63±0.72)mm and (3.43±1.04)mm respectively. On serial transverse plane passed through intercondylar eminence, the longitudinal diameter of tibial collateral ligament was (21.98±11.95)mm and the transverse one  (2.03±0.59)mm, as well the fibular collateral ligament  (5.25±1.93)mm and (2.87±0.64)mm respectively. Conclusions　(1)The adequate plane for observing the cruciate ligament was the mid-sagittal plane and the lateral sagital plane. The lengths and the widths of the attachment region from femur to tibia between anterior cruciate ligament and posterior cruciate ligament were different, however, the thickness is the exception. (2)The collateral ligament can be seen clearly on transverse and coronal planes, especially on coronal ones. (3) Sagittal and coronal planes are better for observing the cruciate ligaments, otherwise, coronal and transverses planes for collateral ligaments.