【摘要】 背景:目前国外学者对半月板的大体解剖学作了一些研究,而国内对成年人正常半月板的研究资料甚少。目的:测量成年人半月板的各项数据,为临床半月板运动损伤提供解剖学基础。设计:重复测量设计。单位:成都医学院科研处。材料:实验于2003-09/2005-09在成都医学院人体解剖学教研室局部解剖实验室完成。收集94例成年人膝关节标本,男48例,女46例,无任何膝关节病变。方法:去除膝关节皮肤、皮下组织及肌肉,髌骨上方切断股四头肌肌腱,打开关节囊,并向关节囊两侧作延长切口至关节囊后壁,暴露前、后交叉韧带,在前交叉韧带起点附近切断,仔细清除关节囊内脂肪垫,由上向下测量成年人离体前、后的内、外侧半月板标本各项数据。主要观察指标:离体前测量:①内侧半月板标本的最大矢状径、外弧长及前角宽度、体部宽度、后角宽度。②外侧半月板标本的最大矢状径、外弧长、最大横径、口长(外侧半月板前后角最边缘之间的距离)、前角宽度、体部宽度、后角宽度。离体后测量:①内侧半月板标本的最大矢状径、外弧长、前角宽度、体部宽度、后角宽度以及前角、体部、后角的外侧缘、中心及游离缘的厚度。②外侧半月板标本的最大矢状径、外弧长、最大横径、口长、前角宽度、体部宽度、后角宽度以及前角、体部、后角的外侧缘、中心及游离缘的厚度。结果:①女性的内、外侧半月板标本各部位测量结果比男性稍小。男性的内、外侧半月板标本测量结果与蒋欣等观测的基本一致。②内、外侧半月板标本的前角、体部及后角从外缘到内侧游离缘,厚度逐渐由厚变薄,呈楔形填充于股骨内、外侧髁及胫骨平台之间。③内侧半月板呈“C”形或半月形,前角附着于胫骨髁间前区,位于前交叉韧带附着点的前方,后角附着于胫骨髁间后区,居外侧半月板后角后方、后交叉韧带附着点的前内侧;内侧半月板离体前后的外弧长变化不明显(t=1.98,P>0.05)。④外侧半月板略呈“O”形,前角附着于胫骨髁间结节前方、前交叉韧带后方,后角附着于胫骨外侧髁间结节后方,位于内侧半月板后角附着点之前;外侧半月板离体前后的外弧长变化不明显(t=0.61,P>0.05),而宽度则变化明显(t=2.49,P<0.05)。结论:所取得的半月板测量数据对临床半月板运动损伤提供了参考依据。更多还原

【Abstract】 BACKGROUND: There have been some foreign studies on the general anatomy of meniscus, while domestic materials about adult normal meniscus are few. OBJECTIVE: To measure the various data of adult meniscus, so as to provide anatomical basis for clinical meniscal sport injury. DESIGN: Repetitive measurement design.SETTING: Department of Scientific Research, Chengdu Medical College.MATERIALS: This experiment was carried out in the Laboratory of Local Anatomy, Department of Human Anatomy, Chengdu Medical College during September 2003 to September 2005. Totally 94 adult knee joint samples, without any diseases were harvested from 94 patients, including 48 male and 46 female. METHODS: Skin of knee joint, subcutaneous tissue and muscle were removed. Tendon of musculus quadriceps fexoris was cut above the whirbone. Articular capsule was open, and incisions were made and prolonged to the posterior wall of articular capsule. Anterior and posterior cruciate ligaments were exposed and cut near the starting point of anterior cruciate ligaments. Fat pad of articular capsule was carefully cleaned. Various data of adult medial and lateral meniscus before and after ex vivo were measured up and down. MAIN OUTCOME MEASURES: Measurement before ex vivo: ① The largest sagittal diameter, the length of outer arc, the width of anterior angle, caudomedial part and posterior angel of medial meniscus. ②The largest sagittal diameter, the length of outer arc, the largest transverse diameter, aperture length ( distance between anterior and posterior angel border of lateral meniscus), the width of anterior angle, caudomedial part and posterior angle of the lateral meniscus. Measurement after ex vivo: ①The largest sagittal diameter, the length of outer arc, the width of anterior angle, caudomedial part and posterior angel as well as the thickness of lateral border, center and free edge of anterior angle, caudomedial part and posterior angel of medial meniscus. ② The largest sagittal diameter, the length of outer arc, the largest transverse diameter, aperture length, the width of anterior angle, caudomedial part and posterior angel as well as the thickness of lateral border, center and free edge of anterior angle, caudomedial part and posterior angel of lateral meniscus.RESULTS: ①The measuring data of medial and lateral meniscus of female samples were a little smaller than those of male samples. The measuring results of medial and lateral meniscus of male samples were basically consistent with the observed results. ②The anterior angle, caudomedial part and posterior angle of medial and lateral meniscus were gradually thinned from lateral border to interior free edge, and they were filled in the plateau between medial or lateral condyles and tibia in wedge shape. ③ Medial meniscus presented "C" or crescent shape. Anterior angle adhered to the anterior intercondylar fossa of tibia which located in the front of the attachment point of anterior cruciate ligament, and posterior angle adhered to posterior intercondylar fossa of tibia which located in the rear of posterior angle of lateral meniscus and in the anteriomedialis of the attachment point of posterior cruciate ligament; There was no obvious changes in the length of outer arc of medial meniscus before ex vivo (t=1.98,P > 0.05). ④The lateral meniscus presented "O" shape a little , and anterior angle adhered to the front part of nodus among condyles of tibia and the rear of anterior cruciate ligament, and the posterior angle adhered to the rear of lateral intercondylar tubercle which located in the front of attachment point of posterior angle of medial menisus; There were no obvious changes in the length of outer arc of lateral meniscus before and after ex vivo (t=0.61,P > 0.05), but obvious changes existed in the width of anterior angle, caudomedial part and posterior angel of medial meniscus (t=2.49,P < 0.05).CONCLUSION: The obtained measuring data of meniscus provide referencing basis for clinical meniscal sport injury.更多还原