新型开放式膝横型径路治疗半月板损伤的解剖学研究

The applied anatomical study of new transverse surgical approach on the treatment of meniscus injury

目的为膝横型径路治疗半月板损伤提供必要的人体结构基本数据。方法 50膝成人下肢标本,取膝屈曲90°~100°,模拟膝横型手术径路,解剖观测横型径路切口及相关主要结构。结果内侧横型径路切口长（55.64±9.82）mm,外侧横型径路切口长（54.82±8.42）mm;隐神经髌下支是内侧模型径路术中易损伤结构,其跨越内侧横型径路处呈宽扁形,宽（1.24±0.38）mm,厚（0.44±0.58）mm,距髌韧带内侧缘（38.42±1.24）mm;膝上、下内侧动脉,膝上、下外侧动脉及胫前返动脉是主要相关血管,穿出深筋膜后在径路上、下方吻合成膝周血管网。结论横型径路切口小,远离较大重要血管,解剖层次结构简单,单一横型径路即可充分显露半月板;术中有效视野广,操作安全有效。

Objective To provide the necessary human basic structure data for new transverse surgical approach on the treatment of meniscus injury.Methods The operation is simulated at 50 cases of adult lower limb specimen with knee flexion90°-100°.The incisions and major related nerves and blood vessels on transverse surgical approach are respectively observed.Results The incision of the medial transverse approach was（55.64±9.82） mm long,the lateral＇s was（54.82±8.42） mm.The infrapatellar branch of saphenous nerve is easy to injure at the medial transverse approach.It was（1.24±0.38） mm wide and（0.44±0.58）mm thick when it cross medial transverse approach.Its distance was respectively（30.76±0.81） mm from the medial border of patellar ligament.The major related blood vessels include medial and lateral superior genicular artery,medial and lateral inferior genicular artery and anterior tibial recurrent artery.They formed blood vessel net each other around knee through the deep fascia.Conclusion The incision of transverse approach is small,farther from the major blood vessels.The anatomical structure and layer is simple and clear,a single transverse approach can fully reveal the meniscus.It is wide field of operation and safe effective for new transverse surgical approach.