踝关节外侧副韧带定量解剖研究

发布时间：2018-01-30 01:43

本文关键词： 踝关节外侧副韧带前距腓韧带跟腓韧带解剖变异系数　出处：《中国运动医学杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的:通过对人体踝关节标本的定量解剖,明确踝关节外侧副韧带相关形态参数及其起止点足印区至各解剖标志的距离,为踝关节外侧副韧带重建手术提供解剖学依据。方法:共选取19例下肢尸体标本,对踝关节外侧副韧带进行精细解剖观察并对相关参数如长度、宽度、厚度及其起止点至各解剖标志的距离进行定量测量。结果:19例人体下肢标本中,前距腓韧带(ATFL)平均长度为23.1±2.98 mm,其中单束8例(42.1%),双束11例(57.9%)。前距腓韧带腓骨起点至腓骨前部结节平均距离(AA)为17.1±3.00 mm,至腓骨隐匿结节(AO)平均距离为5.1±1.69 mm,至腓骨尖(AT)平均距离为14.1±2.86mm,前距腓韧带距骨止点至距骨上下关节面的平均距离分别为11.4±2.25 mm及18.4±2.30 mm,至距骨前外软骨面的平均距离为4.8±1.42 mm。跟腓韧带(CFL)平均长度为31.4±3.55 mm,跟腓韧带腓骨起点至前距腓韧带腓骨起点的平均距离为6.4±2.55 mm,跟腓韧带与前距腓韧带间夹角为116.6±12.69°,跟腓韧带跟骨止点至跟骨外侧结节(CP)平均距离为15.4±2.86 mm,至跟骨后上缘(CC)平均距离为13.9±2.46 mm,至距下关节面(CS)平均距离为15.2±3.21 mm。以变异度衡量各解剖标志相对稳定性结果如下:ATFL腓骨止点AA(17.54%)AT(20.28%)AO(33.14%),CFL跟骨止点CC(17.70%)CP(18.57%)CS(21.1%)。结论:通过解剖研究发现踝关节外侧副韧带形态参数及起止点至各解剖骨性标志的距离存在一定的变异性,为临床上解剖重建踝关节外侧副韧带治疗慢性踝关节不稳定提供了解剖依据。
[Abstract]:Objective: to determine the relative morphological parameters of lateral collateral ligament of ankle and the distance from foot mark to each anatomic mark by quantitative anatomy of human ankle. Methods: 19 cases of lower extremity cadavers were selected for detailed anatomical observation of the lateral collateral ligament of ankle joint, and related parameters such as length and width were observed. Results the average length of ATFLL was 23.1 卤2.98 mm in 19 human lower limb specimens. The average distance between the fibular origin of the anterior talofibular ligament and the anterior tubercle of the fibula was 17.1 卤3.00 mm. The average distance between AOA and ATA was 5.1 卤1.69mm and 14.1 卤2.86mm, respectively. The average distance from the insertion point of the talus to the superior and inferior articular surface of the talus was 11.4 卤2.25mm and 18.4 卤2.30 mm, respectively. The average distance to the anterior outer surface of talus was 4.8 卤1.42 mm. the average length of CFL was 31.4 卤3.55 mm. The average distance between fibular origin and fibular origin of calcaneus fibular ligament was 6.4 卤2.55 mm, and the angle between calcaneal ligament and anterior talofibular ligament was 116.6 卤12.69 掳. The average distance between calcaneal insertion point and lateral calcaneal tubercle was 15.4 卤2.86mm and 13.9 卤2.46mm respectively. The average distance to CSS is 15.2 卤3.21 mm. the relative stability of each anatomic marker measured by variance is as follows: AAATFL fibula insertion point AA17.54A (. 20.28 AO33.14). CFL calcaneal insertion (CCL 17.70). Conclusion: the morphological parameters of lateral collateral ligament of ankle and the distance from the starting and ending point to each anatomic bone mark are found to be variable by anatomical study. It provides anatomic basis for the treatment of chronic ankle instability by anatomical reconstruction of lateral collateral ligament of ankle joint.
【作者单位】：复旦大学附属华山医院运动医学科;
【基金】：国家自然科学基金面上项目(8157090042)
【分类号】：R322.7;R687.4
【正文快照】： 踝关节扭伤占所有运动损伤的10%~15%[1,2],即使通过及时治疗,仍有近30%左右的踝关节扭伤可能发展为慢性踝关节不稳定[3]。踝关节扭伤时的主要损伤结构是踝关节外侧副韧带,包括前距腓韧带(anteriortalofibular ligament,ATFL)、跟腓韧带(calcaneofibularligament,CFL)、后距腓

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