股骨髁间窝的应用解剖及其临床研究

目的 探讨如何完善髌韧带中1／3重建前叉韧带术式，防止重建韧带撞 现象的发生。方法 测量42例和73例正常干、湿性股骨髁间窝标本的横径、纵径及其相关值；通过对湿性膝关节标本股骨髁间窝与前交叉韧带和重建韧带解剖关系的观测，确定膝关节伸展时髁间窝与韧带发生撞击的部位，在髌韧带中1／3重建前叉韧带的模拟和临床手术中， 切除股骨髁间窝前外侧壁及顶部部分骨质，加宽加深髁间窝，保持重建韧带与其有5mm间距。结果 临床应用19例中随访1年以上者11例，无1例出现重建韧带撞击现象，膝关节稳定性恢复良好。结论 股骨髁间窝扩大成形能有效地防止髁间窝对髌韧带的撞击，保证其顺利地替代前叉韧带的功能。

The applied anatomy and clinical study of femoral intercondylar fossa

Objective To improve reconstructive method of damaged anterior cruciate ligament and prevent the reconstructed ligament from being damaged. Methods Femoral intercondylar fossae were anatomized and measured in 42 dry samples and 73 undried ones for breadth,height and relative other values of it. Meanwhile the place of collision between femoral intercondylar fossa and ligament was found in straight knee joint position. After anatomical relations among femoral intercondylar fossa, anterior cruciate ligament and reconstructed ligament were observed in undried knee joint samples. Anterolateral and cupular part of intercondylar fossa was removed in the experimental and clinical application of middle bundle of patellar ligament reconstructing anterior cruciate ligament, which resulted in broadening and deepening intercondylar fossa in order to keep 5 mm interval between reconstructed ligament and femoral intercondylar fossa. Results Nineteen cases of damaged anterior cruciate ligament underwent the operation. Over one year follow up amounted to 11 cases. There was no damage of reconstructed ligament and unstableness of knee joint. Conclusion The operation can not only prevent effectively intercondylar fossa from impinging and damaging the reconstructed ligament, but also guarantee it to replace successfully function of anterior cruciate ligament.