踝三角韧带修复重建的解剖与生物力学的基础研究

发布时间：2017-12-28 04:25

本文关键词：踝三角韧带修复重建的解剖与生物力学的基础研究　出处：《中国临床解剖学杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的通过对尸体标本踝三角韧带进行解剖观测,为踝关节韧带修复重建提供解剖与生物力学基础。方法选取成人新鲜尸体足踝标本10例,观察三角韧带的组成、起止、分布,测量各组成部分的长度、宽度及厚度;并在外翻应力位下拍摄X线片,测量踝关节内侧间隙(Mcs),依次切断三角韧带浅层、深层,并重复上述测量。结果踝三角韧带均分为深、浅两层组成,当踝关节韧带处于完整状态时,踝关节在跖屈、中立及背伸位的平均内踝间隙宽度分别为(2.67±0.38)mm、(2.42±0.35)mm、(2.55±0.24)mm。当踝关节处于中立位及最大背伸位时,切断三角韧带浅层后内踝间隙与完整状态相比均无显著性差异(P0.05),而切断三角韧带深层后内踝间隙与完整状态相比有显著性差异(P0.05);而当踝关节处于最大跖屈位时,所有韧带破坏状态后的内踝间隙与韧带完整时相比均无显著性差异(P0.05)。结论(1)踝三角韧带由4条韧带束组成,各韧带束精确起止点的确定是基础研究及临床解剖重建基础。(2)通过综合踝关节跖屈位、中立位及背伸位外旋应力试验结果,可更全面、准确地诊断三角韧带损伤。
[Abstract]:Objective to provide anatomical and biomechanical basis for the reconstruction and reconstruction of the ankle ligament through the anatomical observation of the ankle deltoid ligament of the cadaver specimens. Methods adult fresh cadaver specimens of 10 cases of ankle, composition, observe the deltoid ligament check, distribution, measuring length, thickness and width of each part; and should take X-ray stress measurement in valgus medial ankle clearance (Mcs), in order to cut off the triangular ligament of shallow and deep, and repeat the above measurement. The deltoid ligament is divided into deep and shallow two layers when the ankle ligament is intact, ankle joint in plantar flexion and dorsiflexion neutral and average gap width of a medial malleolus were (2.67 + 0.38), mm (2.42 + 0.35), mm (2.55 + 0.24) mm. When the ankle joint in neutral position and maximum dorsiflexion, cutting clearance and the complete state of shallow medial malleolus after triangular ligament had no difference (P0.05), and cut the deep triangular ligament and medial malleolus after complete clearance showed a significant difference (P0.05); and when the ankle joint is the maximum plantar flexion when all the ligament damage state of medial malleolus clearance and ligament intact than when there was no significant difference (P0.05). Conclusion (1) the ankle trigonometric ligament is composed of 4 ligamentous ligaments. The determination of the exact starting and stop points of the ligamentous bundles is the basis for the basic and clinical anatomical reconstruction. (2) the damage of the trigonometric ligament can be diagnosed more comprehensively and accurately by combining the results of the metatarsal flexion of the ankle, the neutral position and the external rotation stress test.
【作者单位】：广东省第二人民医院创伤外科;
【基金】：广东省医学科研基金资助项目(A2014146)
【分类号】：R318.01;R322.73
【正文快照】： 踝关节是小腿和足部活动的重要枢纽,是人体日常动作的主要关节,其中维系踝关节稳定最主要的结构为三角韧带,尤其是踝关节内侧的稳定性[1]。关于三角韧带的解剖,由于其模糊的分束及众多的变异,国内研究数量仅为膝关节前交叉韧带1/16,特别是对于韧带起止点未进行深入解剖研究,

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