带血管蒂髌骨移位修复胫骨内侧髁上关节面缺损的应用解剖

APPLIED ANATOMY OF THE PEDICLED PATELLA TRANSPOSITION FOR REPAIRE OF THE SUPERIOR ARTICULAR SURFACE OF THE MEDIAL TIBIAL CONDYLE

为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，采用经动脉灌注的成人下肢标本３７侧，经解剖、厚切片或铸型研究髌骨的血管。观测３０块髌骨和胫骨内侧髁上关节面的形态和面积。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。膝下内动脉和膝降动脉关节支的髌下支在髌骨内下方合并后参与形成髌周动脉环。髌骨的关节面与胫骨内侧髁上关节面形态大小相似。根据研究结果，提出用带血管蒂髌骨移位的方法，利用髌骨的关节面，修复胫骨内侧髁上关节面缺损。

To investigate the feasibility of using the pedicled patella for repaire of the superior articular surface of the medial tibial condyle, 37 lower limbs were studied by perfusion. In this series, there were 34 obsolete specimens and 3 fresh specimens of lower legs. Firstly, the vessels which supply to patella were observed by the methods of anatomy, section and casting mould. Then, the form and area of the patellar and tibial medial conylar articular surface were measured in 30 cases. The results showed: ①the arteries supplied to patella formed a prepatellar arterial ring around patella, and the ring gave branches to patella; ②medial inferior genicular artery and inferior patellar branches of the descending genicular arterial articular branch merge and accede to prepatellar ring at inferior medial part of patella; ③the articular surface of patella is similar to the superior articular surface of the tibial medial condyle on shape and area. It was concluded that the pedicled patella can be transposed to medial tibial condyle for repaire of the defect of the superior articular surface. The function of the knee can be reserved by this method.