带血管蒂髌骨移位修复股骨内侧髁下关节面缺损的应用解剖

目的：研究用带血管蒂髌骨移位的方法修复股骨内侧髁下关节面缺损。方法：用３７侧成人下肢标本，经解剖、厚切片和铸型研究髌骨的血管。观测３０块髌骨和股骨内侧髁下关节面的形态和面积。结果：（１）供应髌骨血液的各支动脉先在髌骨周围吻合成髌周动脉环，再由该环发支进入髌骨；（２）于髌骨内下方参与形成髌周动脉环的膝降血管关节支的髌下支蒂长、径粗、走行位置恒定；（３）髌骨和股骨内侧髁都有宽广的关节面。结论：带血管蒂髌骨可移位至股骨内侧髁，修复下关节面缺损，以期最大限度地保留膝关节的功能。

APPLIED ANATOMY OF THE PATELLA PEDICLED WITH VESSELS FOR REPAIRING THE INFERIOR ARTICULAR SURFACE OF THE FEMORAL MEDIAL CONDYLE

Objective:To search a method using the patella pedicled with vessels for repairing the inferior articular surface of the femoral medial condyle Methods:The vessels supplied to patella were studied on 37 sides of adult lower limbs with the methods of anatomy,section or casting mould The form and area of the patellar and femoral medial condylar articular surface were observed on 30 pieces of the patella and femur Results:(1)The arteries supplied to patella form prepatellar ring round patella The ring branches to patella (2)The inferior patellar branch of the descending genicular vascular articular branch which accedes to prepatellar ring has a big diameter and large length and its course is constant (3)The articular surfaces of the patella and femoral medial condyle are wide Conclusions:The patella pedicled with vessels may be transposed to femoral medial condyle for repairing the defect of its inferior articular surface so that the function of the knee can be reserved