腘肌腱和腓侧副韧带股骨止点的测量及其临床意义

目的　为临床膝关节后外侧角重建术股骨侧骨隧道的定位提供解剖学资料。 方法　选取男女各30例膝关节标本，对膝关节后外侧角仔细解剖分离，测量腓侧副韧带和腘肌腱股骨附丽部中心与股骨外上髁位置关系、两者中心点的距离以及附丽部的面积。 结果　腓侧副韧带附着面积为(47.25±　14.69)mm2，其中男性为(50.22±9.72)mm2，大于女性的(44.29±12.33)mm2；腘肌腱附着面积为(56.18±13.88)　mm2，其中男性为(60.57±12.44)mm2，大于女性的(51.79±13.68)mm2。腓侧副韧带附丽部中心在股骨外上髁近端(1.29±2.73)mm，后方(3.53±2.12)mm，腘肌腱附丽部中心在股骨外上髁远端(8.47±3.34)mm，后方　(3.86±2.09)mm。腓侧副韧带和腘肌腱两者股骨附丽部中心的距离平均为(10.12±3.06)mm，男性为(11.32±　3.69)mm，女性为(8.92±3.25)mm。 结论　两者附丽部的面积和中心距离存在性别差异（P<0.05），本实验的解剖数据可以为临床重建术中定位骨隧道提供参数值。

The anatomical research and clinical significance of the femoral insertions of fibular colfibular ligament and popliteus tendon

Objective　To obtain the anatomical data of the femoral insertions of the fibular collateal ligament (FCL) and the popliteus tendon (PT) for the posterofibular corner reconstruction.　Methods　60 human cadaveric knees, including 30 from males and females, respecitively, were investigated in our study. The cadavers had an average age of 54 , ranging from 42 to 73 years old. 60 cadaveric knees were dissected to identify the femoral insertions of FCL and PT; the distances between the centers of the two insertions and between each center of the insertions to the fibular epicondyle were measured. The surface areas of the insertions were also measured.　Results　The insertion areas of FCL and PT were significantly larger in men (50.22±9.72 mm2 for FCL and 60.57±12.44 mm2 for PT) than in women (44.29±12.33 mm2 for FCL and 51.79± 13.68 mm2 for PT), and the average insertion areas of femur were 47.25±14.69 mm2 for the FCL and 56.18± 13.88 mm2 for the PT, respectively. The FCL inserted a mean of 1.29±2.73 mm (1.34±3.26 mm for men and 1.25±3.11 mm for women) proximal and 3.53±2.12 mm (4.07±1.61 mm for men and 2.99±1.54 mm for women) posterior to the fibular epicondyle; the PT inserted a mean of 8.47 mm (8.93±3.23 mm for men and 8.01±2.89 mm for women) distal and 3.86±2.09 mm(4.21±1.98 mm for men and 3.51±2.11 mm for women) posterior to the fibular epicondyle. The distance of the two centers of insertions of FCL and PT was 10.12±3.06 mm, which was significantly larger in men (11.32±3.69 mm) than in women (8.92±3.25 mm).　Conclusion　The average femoral insertion areas of the FCL and PT and the distance of the two centers of the insertions of FCL and PT were significantly larger in men compared with women. The data provided in this study can help locate the tunnels for reconstruction of the posterofibular structures of the knee.