带血管蒂髌骨移位修复胫骨内侧髁上关节面缺损的解剖与临床

Clinical Anatomy and Application of Patella Pedicled with Vessels for Repairing Superior Articular Surface of Tibial Medial Condyle

目的:探索用带血管蒂髌骨移位的方法,修复胫骨内侧髁上关节面缺损。方法:用经动脉乳胶灌注的下肢标本37侧,经解剖、厚切片和铸型等方法研究髌骨的血管;观测30块髌骨和胫骨内侧髁上关节面的形态和面积。结果:供应髌骨血液的动脉有多条,这些血管先在髌骨周围相互吻合成髌周动脉环,再由该环发支供应髌骨。于髌骨内下方参与形成髌周动脉环的膝降动脉关节支的髌下支或膝下内动脉干长、位置恒定。髌骨和胫骨内侧髁上关节面的形态和面积相似。结论:带血管蒂髌骨可以移位至胫骨内侧髁,利用髌骨的关节面修复胫骨内侧髁上关节面的缺损,以保留膝关节的功能。

To search a method of repairing the superior articular surface of the tibial medial condyle with patella pedicled with vessels.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 tibial medial condylar articular surface were observed on 30 cakes of the patella and tibia. The arteries supplied to patella form prepalellar ring round patella. The ring branches to patella. Medial inferior genicular artery and inferior patellar branch of the descending genicular arterial articular branch merge and accede to prepatellar ring on inferior medial to patella. The articular surface of patella is similar to the superior articular surface of the tibial medial condyle on form and area. According to the results, the patella pedicled with vessels may be transposed to tibial medial condyle for repairing the defect of its superior articular surface so that the function of the knee can be reserved .