Weinstabl R, Scharf W, Firbas W
I. Univ Clinic of Traumatology, University of Vienna, Austria.
Surg Radiol Anat. 1989;11(1):17-22. doi: 10.1007/BF02102239.
Anatomic dissections of the vastus medialis m. in 115 fixed thigh specimens always demonstrated a clear separation between a long head of the muscle (VML) inserted at the base of the patella and a short head (VMO) inserted at its medial margin. The plane of separation was identified by a branch of the femoral n. in every case. In 17 instances, the localization of the nerve was superficial; in 57, it was in the areolar fascial plane; and in 41 instances in lay deeply between the muscles. The ramification of the branch of the femoral n. traversing the plane of separation showed 4 types of variation. Dissections of the vastus lateralis m. in 42 specimens always demonstrated a separation into 2 heads: a long head inserted at the base of the patella (VLL) and a short head inserted at its lateral margin (VLO). The directions of the individual heads of the quadriceps femoris m. were angulated in relation to the long axis of the femur. The deviations were between 10 degrees and 17 +/- 8 laterally for the vastus lateralis longus m. (VLL), between 26 degrees and 41 degrees laterally for the vastus lateralis obliquus m. (VLO), between 15 degrees and 18 degrees medially for the vastus medialis longus m. (VML), and between 46 degrees and 52 degrees medially for the vastus medialis obliquus m. (VMO). The results demonstrate great variation in the distal parts of the medial and lateral anterior thigh m.
在115个固定的大腿标本上对股内侧肌进行解剖时，总是能清楚地看到，插入髌骨底部的肌长头（股内侧肌长头）与插入髌骨内侧缘的肌短头（股内侧肌斜头）之间存在明显分离。在每种情况下，分离平面都由股神经的一个分支确定。在17例中，神经位于浅表；在57例中，位于疏松结缔组织筋膜平面；在41例中，深埋于肌肉之间。穿过分离平面的股神经分支的分支显示出4种变异类型。在42个标本上对股外侧肌进行解剖时，总是能看到其分为两个头：插入髌骨底部的长头（股外侧肌长头）和插入髌骨外侧缘的短头（股外侧肌斜头）。股四头肌各头的方向相对于股骨长轴呈一定角度。股外侧肌长头（VLL）向外的偏差在10度至17°±8度之间，股外侧肌斜头（VLO）向外的偏差在26度至41度之间，股内侧肌长头（VML）向内的偏差在15度至18度之间，股内侧肌斜头（VMO）向内的偏差在46度至52度之间。结果表明，大腿前内侧和外侧远端肌肉存在很大变异。
