膝关节半月板和交叉韧带的断层解剖学研究

Sectional anatomy of the meniscus and cruciate ligaments

目的 观察膝关节半月板和交叉韧带的断面形态特征 ,为半月板和交叉韧带损伤的影像学诊断提供解剖学依据。方法 利用 47侧经福尔马林液防腐固定后的成人膝部标本 ,冷冻后用断层带锯作厚 5mm的横、矢和冠状连续断层 ,对各断层面的半月板和交叉韧带进行观察。结果 半月板后角高度明显高于前角 ,内侧半月板前窄后宽 ,而外侧半月板宽度前、后角基本一致。正中矢状面显示交叉韧带全长的出现率为 79.5 %,前交叉韧带与矢状面的夹角较后交叉韧带小。结论 膝关节断层形态学研究提示半月板的后角容易损伤 ;外侧半月板较内侧更易损伤。影像诊断半月板和交叉韧带的损伤应以矢状面为重点 。

Objective To provide the morphological basis for the imaging diagnosis of the injured meniscus and cruciate ligaments by observation of the sectional anatomical properties of the meniscus and cruciate ligaments. Methods A total of 47 sides of adult genicular specimens were used, and serial transverse, sagittal, and coronal sections of 5 mm in thickness were made respectively. Meniscus and cruciate ligaments on each section were observed. Results The posterior horn of meniscus was distinctly higher than its anterior horn. The posterior horn of the medial meniscus was wider than its anterior horn, but no difference in the width of posterior and anterior horns in the lateral meniscus was found. The rate of full long cruciate ligaments observed on the median sagittal plane was 79 5%, and the angle formed by the anterior cruciate ligament and the sagittal plane was smaller than that formed by the posterior cruciate ligament and the sagittal plane. Conclusion The sectional anatomy of the knee joint suggests that the posterior horn of meniscus is susceptible to be injured; the lateral meniscus is much easier to be injured than the inferior meniscus. Examination of the sagittal planes combined with that of the coronal planes should be focused when imaging diagnosis of the injured meniscus and cruciate ligaments is performed.