Ivey M, Prud'homme J
University of Texas Medical Branch, Div of Orthopedic Surgery, Galveston 77550.
Orthopedics. 1993 May;16(5):601-6. doi: 10.3928/0147-7447-19930501-14.
Both knees of 51 cadavers were dissected to identify anatomic variations of the pes anserinus. The tendons of the sartorius, gracilis, and semitendinosus were exposed through an inverted L subperiosteal incision beginning at the crest of the tibia. The upper border of the gracilis tendon was located an average of 5.5 cm from the anteromedial joint line. The tendons of the gracilis and semitendinosus fuse an average of 3.18 cm from their insertion and are firmly adherent to layer I (sartorius tendon). Forty-eight percent of the specimens demonstrated at least one of seven variations, ranging from fascial loops connecting the sartorius tendon with the medial collateral ligament to separate tendon slips from each of the three tendons inserting separately into the tibia or the crural fascia. This exposure is recommended to safely and efficiently dissect the tendons of the pes anserinus for use in reconstructive procedures of the knee.
对51具尸体的双侧膝关节进行解剖,以确定鹅足的解剖变异情况。通过始于胫骨嵴的倒L形骨膜下切口暴露缝匠肌、股薄肌和半腱肌的肌腱。股薄肌腱的上缘距关节前内侧线平均为5.5厘米。股薄肌和半腱肌的肌腱在距其止点平均3.18厘米处融合,并牢固地附着于第I层(缝匠肌腱)。48%的标本显示出七种变异中的至少一种,范围从连接缝匠肌腱与内侧副韧带的筋膜襻到三条肌腱各自分开的肌腱束分别插入胫骨或小腿筋膜。建议采用这种暴露方式,以便安全、有效地解剖鹅足肌腱,用于膝关节重建手术。