带血供半腱肌肌腱条骨块重建后交叉韧带的应用解剖

目的　为带血供骨 半腱肌肌腱条骨块转位重建后交叉韧带 (PCL)提供应用解剖学基础。方法　在 5 0侧成人下肢标本上观测半腱肌肌腱的形态、血供来源、分支及分布特点和股骨内侧髁及后交叉韧带的形态 ;2侧新鲜下肢标本进行摹拟术式。结果　半腱肌腱长约 15 2cm× 0 5cm× 0 4cm ,血供主要来源于动脉的半腱肌支、膝下内侧动脉的腱支和腱外周组织血管网。肌门位于半腱肌外后 ,距股骨内上髁上方约 3 6cm ;后交叉韧带长约 3 6cm× 1 0cm× 0 6cm ;股骨内侧髁关节面中点前后径约为 4 3cm ,左右径约为 3 0cm。结论　半腱肌肌腱与后交叉韧带形态相似、有足够的游离长度。血供丰富为多源性。故采用带血供的半腱肌肌腱条骨块是重建后交叉韧带较理想的替代物。

Applied anatomy of rebuilding posterior cruciate ligament of knee by the transposition of bone-semitendinous muscle tendon cord with blood supply

Objective To supply the basis of applied anatomy for rebuilding posterior cruciate ligament of knee by the transposition of bone semitendinous muscle tendon with blood supply.Method The figure,the origin of blood supply,the branches and the characteristics of semitendinous muscle tendon,trgether with the figure of medical mallelus of femur and posterior cruciate ligament of knee were observed and measured on 50 samples of adult lower extremity spectmens;2 flesh lower extremities were used to carry out simulated operation.Results Semitendinous muscle tendon was about 15 2 cm×0 5 cm×0 4 cm.Its blood supply mainly came from the semitendinous muscle branch of arterial poplitees, the tendon branch of arteria genus inferior medialis and the peripheral tissue and vascular net of the tendon.Muscle hilum lied in the posterior and external of semitendinous muscle,about 3 6 cm from the upper of internal epicandyle of femur;posterior cruciate ligament of knee was abort 3 6 cm×10 cm×0 6 cm.The anteroposterior diameter and left right diameter of the middle point of internal maueolar facet of tibia of femur were 4 3 cm and 3 0 cm respectively.Conclusion Semitendinous tendon has the same figure with posterior cruciate ligament of knee,its free length is enough,its blood supply is also very rich and has many origins. It is easy of its survival and restoration of its function to rebuild posterior cruciate ligament of knee with bone semitendinous muscle tendon cord.