Greenwood Kelsi, Zyl Reinette van, Keough Natalie, Hohmann Erik
Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Department of Anatomy and Cellular Biology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates.
Anat Cell Biol. 2021 Mar 31;54(1):10-17. doi: 10.5115/acb.20.179.
Surgical access to the posterior knee poses a high-risk for neurovascular damage. The study aimed to define the popliteal fossa by reliable bony landmarks and comprehensively mapping the neurovascular structures for application in posterior knee surgery. Forty-five (20 male, 25 female) embalmed adult cadaveric knees were included. The position of the small saphenous vein (SSV), medial cutaneous sural nerve (MCSN) and lateral cutaneous sural nerv (LCSN), tibial nerve (TN) and common fibular nerve (CFN) nerves, and popliteal vein (PV) and popliteal artery (PA) were determined in relation to either medial (MFE) or lateral (LFE) femoral epicondyles, medial (MTC) and lateral (LTC) tibial condyles and the midpoint between the MFE and MTC and LFEF and LTC. The distance between the MFE and the PA, PV, TN, MCSN, and SSV was 38.4±12.1 mm, 38.4±12.9 mm, 39.4±10.2 mm, 39.2±14.0 mm and 37.6±12.5 mm respectively for males and 34.6±4.9 mm, 32.8±5.6 mm and 38.0±8.1 mm 38.8±10.1 mm and 37.9±8.2 mm respectively for females. The distance between LFE and the CFN and LCSN was 13.4±8.2 mm and 24.9±7.3 mm respectively for males and 8.4±9.1 mm and 18.4±10.4 mm respectively in females. This study defined the popliteal fossa by reliable bony landmarks and provided a comprehensive map of the neurovascular structures and will help to avoid injuries to the important neurovascular structures.
手术进入膝关节后方存在神经血管损伤的高风险。本研究旨在通过可靠的骨性标志来界定腘窝,并全面绘制神经血管结构,以应用于膝关节后方手术。纳入了45个(20例男性、25例女性)防腐处理的成年尸体膝关节。确定了小隐静脉(SSV)、腓肠内侧皮神经(MCSN)和腓肠外侧皮神经(LCSN)、胫神经(TN)和腓总神经(CFN)以及腘静脉(PV)和腘动脉(PA)相对于内侧(MFE)或外侧(LFE)股骨髁、内侧(MTC)和外侧(LTC)胫骨髁以及MFE与MTC、LFE与LTC之间中点的位置。男性中,MFE与PA、PV、TN、MCSN和SSV之间的距离分别为38.4±12.1毫米、38.4±12.9毫米、39.4±10.2毫米、39.2±14.0毫米和37.6±12.5毫米;女性中分别为34.6±4.9毫米、32.8±5.6毫米、38.0±8.1毫米、38.8±10.1毫米和37.9±8.2毫米。男性中,LFE与CFN和LCSN之间的距离分别为13.4±8.2毫米和24.9±7.3毫米;女性中分别为8.4±9.1毫米和18.4±10.4毫米。本研究通过可靠的骨性标志界定了腘窝,并提供了神经血管结构的全面图谱,将有助于避免重要神经血管结构的损伤。