Terry G C, LaPrade R F
Hughston Clinic, PC, Columbus, Georgia 31908-9517, USA.
Am J Sports Med. 1996 Jan-Feb;24(1):2-8. doi: 10.1177/036354659602400102.
We dissected 30 cadaveric knees to provide a detailed anatomic description of the biceps femoris muscle complex at the knee. The main components of the long head of the muscle are a reflected arm, a direct arm, an anterior arm, and a lateral and an anterior aponeurosis. The main components of the short head of the biceps femoris muscle are a proximal attachment to the long head's tendon, a capsular arm, a confluens of the biceps and the capsuloosseous layer of the iliotibial tract, a direct arm, an anterior arm, and a lateral aponeurosis. We examined 82 consecutive, acutely injured knees with clinical signs of anterolateral-anteromedial rotatory instability for the incidence and anatomic location of injuries to the biceps femoris muscle. Injuries to components of that muscle were identified in 59 (72%) of these knees; 29 knees (35.4%) had multiple components injured. There were 3 injuries to the long head of the biceps femoris muscle (all in the reflected arm) and 89 to the short head. A statistically significant correlation (P = 0.01) was found between increased anterior translation with the knee at 25 degrees of flexion as demonstrated by the Lachman test and injury to the biceps-capsuloosseous iliotibial tract confluens. Additionally, adduction laxity at 30 degrees of flexion correlated with a Segond fracture (P = 0.04). These data establish, in part, the relationship of the biceps femoris complex injury to anterior translation instability.
我们解剖了30具尸体膝关节，以详细描述膝关节处股二头肌复合体的解剖结构。该肌长头的主要组成部分为反折臂、直接臂、前臂以及外侧和前腱膜。股二头肌短头的主要组成部分为近端附着于长头肌腱、关节囊臂、股二头肌与髂胫束关节囊骨膜层的汇合处、直接臂、前 臂以及外侧腱膜。我们检查了82例具有前外侧-前内侧旋转不稳定临床体征的急性损伤膝关节，以了解股二头肌损伤的发生率和解剖位置。在这些膝关节中，有59例（72%）发现该肌各组成部分有损伤；29例膝关节（35.4%）有多个组成部分受损。股二头肌长头有3处损伤（均在反折臂），短头有89处损伤。通过拉赫曼试验发现，膝关节在25度屈曲时前向平移增加与股二头肌-髂胫束关节囊骨膜层汇合处损伤之间存在统计学显著相关性（P = 0.01）。此外，30度屈曲时的内收松弛与Segond骨折相关（P = 0.04）。这些数据部分确立了股二头肌复合体损伤与前向平移不稳定之间的关系。
