膝关节不同屈伸状态下髂胫束的形态学研究

morphological study of iliotibial band at the flexion and extension status of knee joint

目的 :研究正常青年人在膝关节不同屈伸状态下髂胫束(iliotibial band,ITB)与股骨外上髁的距离变化及ITB长轴与股骨干长轴的夹角关系。方法:男女青年志愿者各50人,通过体格检查和B超分别测量ITB宽度、厚度;并在膝关节伸直位、屈曲30°、屈曲90°及屈曲135°位时测量ITB与股骨外上髁的距离及ITB长轴骨长轴的夹角。结果:方差分析均显示,男女两组志愿者不同膝关节屈伸程度时ITB与股骨外上髁的平均距离不等(P<0.01),随着膝关节屈曲程度增大,股骨外侧髁水平的ITB中心点逐渐由股骨外侧髁前方向后方移动。两组志愿者不同膝关节屈伸体位时ITB长轴与股骨长轴的平均夹角角度不等,且存在统计学差异。当膝关节由伸直位向屈曲位变化过程中,ITB长轴逐渐由股骨长轴后方向前方偏转。男性组的ITB平均宽度大于女性组(P<0.01),ITB平均宽度、厚度大于女性组(P<0.01)。结论:健康男女青年当膝关节屈曲时,ITB均由股骨外侧髁前方向其后方滑动,屈曲30°时与股骨外侧髁摩擦最为明显这可能是导致髂胫束综合征的病因之一。

Objective：The purpose of this study was to study the distance of iliotibial band （iliotibial band, ITB）and lateral femoral condyle and the angle of ITB long axis with long femoral shaft in the condition of different knee flexion in normal young subjects. Method：One hundred asymptomatie volunteers （50 men and 50 women）participated in the study. The thickness and width of ITB were measured by sonographic and physical examination. The distance of ITB and lateral femoral condyle and the angle of ITB long axis with long femoral shaft were also measured in different the knee joint positions,which were extension,30° ,90° and 135° flexion. Result： ANOYA shown that the average distance of ITB and the lateral femoral epicondyle varied significantly according to different positions of knee joint （P 〈 0.01 ）in either group. At the level of the lateral femoral condyle ,ITB center gradually shifted from anterior to posterior of the lateral femoral condyle with the increasing of knee joint flexion. There was a significant difference in the average angle of ITB long axis with long femoral shaft according to different positions of knee joint using ANOVA （P 〈 0.01 ）in both groups. ITB axis gradually shifted from posterior to anterior of femoral shaft axis with the increasing of knee joint flexion. ITB average width and average thickness were statistically increased in male group using t-test （P 〈 0.01 ）. ITB gradually shifts from anterior to posterior of femoral shaft with the incensement of knee joint flexion in healthy subjects. Conclusion：When knee joint occurs near 30° of flexion,the iliotibial band and the lateral femoral condyle friction is most prominent,which may one of causes of iliotibial band syndrome.