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1、膝关节内侧结构的解剖学研究背景膝关节内侧的解剖已经在质量上有描述，但是内部的主要结构附着点还没有报道。研究的目的是定性膝关节内侧结构的解剖，对膝关节解剖附着点及相关骨性标志的关系做数量上的评估。方法共有8个不成对的新鲜的冰冻尸体膝关节，应用电磁的三维跟踪传感器对切面进行观察和测量。结果除了内侧髁和内收肌结节，第三个骨性突起腓肠肌结节，与内侧腓肠肌的附着部位相当应经鉴定。表面的内侧副韧带得到长度平均是.内侧副韧带表面的近段股骨附着点是长，内上髁后方.内侧副韧带表面在胫骨上距离关节.深层的内侧副韧带由半月板股骨部分和半月板胫骨部分组成。后方的斜韧带股骨附着点距离内收肌结节远端，后方,距离腓肠肌结节
2、远端和前方.内侧髌股韧带在股骨上附着点距离内收肌结节前方毫米和远端毫米。结论膝关节内侧韧带结构有一致的附着类型。临床证据腓肠肌结节和数据关系对于解剖修复和重建膝关节内侧结构复杂的韧带损伤是有的来源于Fig.EPrc*c&ia3ofa怕下LtfBE5btnet5iie：imericistal-medisvkreewith口口wrsrifimnstfaiirifitnFneiricm前cstie;网干栏rtremediaerccncikiE(MFt,tnesddjcTcrhibeie(A-),Midtliegasvxneniij&LuberceGT).?)ecotsareplacetatU由r目自
3、s:pointofeach51rLic山咱.ME来源于股骨样本的照片(远端内测观，右膝)指针表明内上牌(内收肌结节（AD以及腓肠肌结节（GT之间的关系sMCLtproxininl tibial)ligaTnentMeni$cotibial ligamentAMTPOLFig.2Illustrationofthefemoralosseouslandmarksandattachmentsitesofthemainmediakneestructures,AT=adductortubercle,GT=gastrocnemiustubercletMEimedialepicondyle,AM-=adduc
4、tormagnustendon.MGT=medialgastrocnemiusterdon.sviCL=superficialmedialcollateralligannent.MPFL=medialpatellofemoralligament,andPOL-posteriorobliqueligament.股骨的骨性标记和膝关节内侧主要结构的附着位置示意图。内收肌结节（AT）,腓肠肌结节（GP,内上镖（ME,AMT大收肌腱，MGT=侧腓肠肌肌腱，sMCL我层内侧副韧带，MPFL内侧眼股韧带，POL后斜韧带,lit汶尿 tendonAMTsMCLDirect arm ofSMAnterior
5、arm olSMMcdiJlFig. 3Illustration of th6 main mfidi5l knee struCtures (right kn&). VMO = vastus medialis obliquus muscle. MPFL = medial patellofemoral ligament. POL = posterior oblique ligament. sMCL= superficial medial collateral ligament* SM = semimerribranosus muscle, MG= medial gastrocnemius tend
6、on, and 入MT = adductor magnus tendon.膝关节内侧主要结构示意图。VMO=内侧肌，MPFL内侧眼股韧带,POL后斜韧带，sMCL能层内侧副韧带，SM半膜肌，MGT内侧腓肠肌肌腱，AMT大收肌腱Fig. 4illustration of the superficial median collateral ligament (sMCL) (medial aspect, left knee), The proximal forceps are ureter the anterior edge of the femoral portion, and 廿ie dista
7、l hemostat is between the proximal and distal tibia attschmonts. SM =and POL =posterior oblique ligamentFemoralsMCLMedialmeniscusSM tendonTibiaMsMCL Pes tendonsreflected浅层内侧副韧带的示意图(sMCL)(内侧面，左膝关节)。近端的钳子在股骨部分的前缘，远端的止血钳子在近端和远端胫骨附着部位之间。SM半膜肌，POL后斜韧带Fig.5Photographofthemeniscofemonal(MF)andmeniscoibial(
8、VT)portionsofthedeepmedialcollateralligament(medialaspect,eftknee)withtheposteriorobliqueligamentandremainingmedialcaps-uieremoved.Theasteriskindicatesthefemoralattachmentsiteofsup&rfi-dalmedialcollateralligament.MM=posterioraspectofmedialmeniscus,MFC=posterioraspectofmedialfemoralcondye,andMTP=post
9、erioraspectofmedialtibialplateau.内测深层副韧带的半月板股骨(MF和半月板胫骨(MT)部分(左膝内侧面观)，带有后斜韧带并去除内测关节!1。星号表示浅层内侧副韧带股骨上的附着位置。乂乂内测半月板后面，MFC内测股骨牌的后面,MTP内测胫骨平台的后面MGTCapsular armCentral armsMCLSuperficial arm后斜韧带三个臂的示意图（右膝，后内侧），sMCL浅层内侧副韧带,SM半膜肌，MGT=测腓肠肌，OPL躯斜韧带Fig.7-AAtta ch me in site of sMCL (removed)teffdonAnterior ar
10、m of SMxpan si duSMDistal attachment site of tibial sMCL (re moved)Medial meniscusAdduclor magnusSuperficialarm ol POLMedialgastrocnemiustendonFig.7-APhotograph(Fig.7-A)andillustration(Fig.7-B)demonstratingthecentralarm(CA)oftheposteriorobliqueligament(medialaspect,rightknee).Theasteriskindicatesthe
11、femoralattachmentofthesuperficialmedialcollateralligament(sMCL)(removed).Thetipoftheforcepsisatthemedialgastrocnemiusattachment(removed).MGT=medialgastrocnemiustendon,SM=semimembranosustendon,MFC=anterioraspectofmedialfemoralcondyle,ME=medialepicondyle,POL=posteriorobliqueligament,andVMO=vastusmedia
12、lisobliquusmuscle.Fig.7-BIllustrationofthethreearmsoftheposteriorobliqueligament（posteromedialaspect,rightknee）.sMCL=superficialmedialcollateralligament,SM=semimembranosusmuscle,MGT=medialgastrocnemiustendon,andOPL=obliquepoplitealligament.7-A和7-B表示后斜韧带的中央臂（右膝内侧面观），星号表示浅层内侧副韧带的股骨附着点，已经移除，钳子的尖端在内侧腓肠肌
13、的附着部位，MGT内测腓肠肌腱，SM半膜肌肉肌腱，MFC股骨内侧牌的前面，ME=上镖，POL后斜韧带，VMO殿内侧肌肉Fig.7-B后斜韧带三个臂的示意图（右膝后内侧面），sMCL浅层内测副韧带,SM半膜肌肉肌腱，MGT=测腓肠肌腱，OPL=后斜韧带Photographoftheisolatedmedialpatellofemoralligam&nt(MPFL)withttieposteriorvastusmediallisoblliquuseVMO)fiberselevatedofftheligament(medianview,rightknee).Theneedledriverisunde
14、rthemedialpat&llofemoralligament,andthepointerisatthedistaledgeofthemec国DatellofeiToralligament,Theaeeoermedialcsiosulehasbeerremoved.AMT=adductormagnustendon,p=pat6lld,andSM=semrmembranosustendon.用后方股四头肌纤维(抬高已经分离的内侧眼股韧带(MPFL(右膝内侧观)图像。针在内侧眼股韧带下方，所指在内侧眼股韧带的远端。已经去除深部内侧关节囊。人乂丁=大收肌腱p=眼骨，SM半膜肌腱Photogrsph
15、ofWefemoralattachmertoftheadductomagrustendon(AM-)anditsfascialexpansion(arrows)tothemedialgastrocnemiustendon(MGT)an-dposteromedialcapsule(PMC)(medialview,恸tknee),TheforcepsisboldingtheanterioredgeofsuperficialmedialcolateraligamentisMCL),SV=senniiriennbranosListendon.图像股骨的附着点包括内收肌拉大的肌腱（AMT）及其附着到内侧腓肠肌（MGT上的扩展部分（箭头）和后内侧关节囊（PMC（右膝,内侧观）。钳子正在夹住浅层内侧副韧带（Smcl）的前缘。MPFLGTPOLattach mcn.1 BiLEMcdid as trocn-cmius Jon (relrjcte
