腘腓韧带的解剖生物力学特点及其临床意义

目的：研究腘腓韧带的解剖学特点,及其在膝关节运动中的生物力学稳定机制.方法：在15具成人尸体30例膝关节标本上,于膝关节后外侧区域,解剖观察腘腓韧带的位置、组成和形态学特点.以自制夹具固定标本,观察并记录选择性切断腘腓韧带前后的不同工况下,膝内翻加载移位和胫骨上端的后外侧旋转加载移位的变化.结果：①腘腓韧带位于膝关节后外侧区域,邻近上胫腓关节,是连接腓骨头后上方与腘肌腱的韧带样结构.根据腘腓韧带在腘肌腱上附着点的区别,分为前、后两束.②离断腘腓韧带后,应力加载下,膝内翻移位不明显,胫骨上端后外侧旋转移位明显增大.结论：①腘腓韧带是膝后外侧重要的稳定结构;②腘腓韧带具有明显对抗膝后外侧旋转不稳定的作用;③腘腓韧带损伤严重导致膝关节后外侧旋转不稳的,应手术重建腘腓韧带以维持膝关节的稳定性.

Anatomic and biomechanical study of popliteofibular ligament and its clinical significance

Objective:To study the anatom ic featuresofpopliteofibularligam ent,and explore itsstabilitymechanism in knee motion. M ethods: By perform ing anatom ic dissection on 30 knees of 15 cadavers,w eobserved the location, component, morphologic characteristics of popliteofibular ligament (PFL) atposterolateral area of the knee. With a specially designed rig mounting the specimens applied by a constantforce, we investigated knee varus displacement and the translation of upper tibia posterolateral rotation, beforeand after PFL being cutted. Results:1.PFL located in the posterallateralaspectofknee,adjunctto superiortibiofibular synthesis was a ligament-like structure linking the posterosuperior area of fibular head and poplitealtendon. According to its attachments on popliteal tendon, the PFL can be divided into anterior and posteriorbands. 2. Sectioning the PFL resulted in increased posterolateral rotation of the upper tibia, but insignificantknee varus displacement. Conclusions:1.PFL isan im portantstructure forknee stability in knee posterolateralstructures; 2. PFL has a significant role in preventing knee posterolateral rotatory instability; 3. If the PLC isinjured severely, it will be necessary to restore the knee stability for restricting abnormal posterolateral rotationby PFL reconstruction.