股外侧肌腱与股骨外侧髁接触的解剖学观察及其临床意义

The anatomical observation and clinical relevance of the contact between inner surface of lateral femoral tendon and lateral femoral condylar

目的：探讨髌骨半脱位致髌骨外侧软骨面压力过高的形态学因素。方法：对５０侧膝关节标本股外侧肌腱内面及其与股骨外侧髁的接触进行了解剖学观察。结果：股外侧肌腱内面呈椭圆形或圆形光滑面。其周围有滑膜皱襞附着，其长２．１±０．９（１．０～５．４）ｃｍ，宽１．３±０．４（０．７～２．４）ｃｍ，与髌上囊以皱襞相隔。在屈曲９０°时与股骨外侧髁边缘相接触，接触处为光滑的骨软骨结构约１．０ｃｍ×０．８ｃｍ大小。摸拟髌骨半脱位时，整个股四头肌腱外移，股外侧肌腱内面与股骨外侧髁不能接触。结论：①在正常情况下股外侧肌腱内面与股骨外侧髁存在着接触，这可能是缓解髌骨外侧关节软骨面压力的正常接触；②当髌骨半脱位时，该接触减小或消失。

Objective:To study the morphological factor in the excessive lateral pressure syndrome caused by subluxation of patella.Methods:We observed the inner surface of the lateral femoral tendon,lateral femur condylar and their contact.Results:The inner surface of lateral femoral tendon is oral or round in shape with the synoidial plical attached.The length of the surface was 2.1±0.9 cm and with 1.3±0.4 cm in width.There was a plica between the inner surface of lateral femoral tendon and the inner surface of quadriceps tendon.The inner surface of lateral femoral tendon contacted with the lateral femur condylar with a contact area of 1.0cm×0.8 cm when the kness flexed in 30°～90°.This contact area will disappear or decrease in subluxation of the patella because of the lateral dislocation of total tendon quadriceps.Conclusions:There is a normal contact area between the inner surface of lateral femoral tendon and lateral femur condylar to reduce the contact pressure of the lateral surface of patella.In subluxation of patella,the disappear of the contact may be one of the cause in the excessive lateral pressure syndrome.