踝关节力学中心点及其毗邻关系的X线与尸体解剖测量

发布时间：2018-04-01 12:38

本文选题：踝关节中心　切入点：体表标志　出处：《山东中医药大学》2005年硕士论文

【摘要】：目的探讨踝关节力学中点的确切位置,通过X线摄片和对踝关节尸体标本解剖两种方法对两踝连线中点、(口母)长伸肌腱外缘及足背动脉三个标志点进行测量对比,以确定最接近踝关节力学中点的解剖标志,为全膝关节置换手术时下肢力线的准确定位提供依据。材料与方法 1.128例踝关节无疾病和畸形的成年人,年龄18～60岁,平均43.9岁,分别在内外踝连线中点和足背动脉与踝横纹交点做标记M、A,用CR-X线机摄踝关节标准前后位像,并在计算机上测量距骨项在踝横纹处投影的中点C′到以上两个标记点的投影A′、M′的距离和A′、M′间的距离,以C′为中心,与其重叠为零,位于其外侧为正值,位于其内侧为负值,记录结果。 2.在24例(17男7女)48侧成人下肢解剖标本上使用克氏针定位在内外踝连线中点定位,测量自两踝连线中点穿入的克氏针与距骨顶部中点以及其与足背动脉和(口母)长伸肌腱外缘的距离及关系;测量足背动脉外径及其在踝间连线(距骨上缘)上距内外踝关节面的距离;测量(口母)长伸肌腱在胫距关节线平面的横径及其与内外踝关节面的距离,观察其与足背动脉的解剖关系。结果: 1.通过放射学方法,在计算机X线影像上测得两踝连线中点投影M′有96例位于距骨顶部中点C′点外侧,20例与C′点重合,12例位于C′点内侧,平均距离为1.98mm,统计学分析t值为4.272,标准差(S)为0.178,P=0.01960.05,足背动脉与踝横纹交点投影A′有21例位于C′点外侧,31例与其重合,76例位于其内侧,平均距离为—0.40mm,标准差(S)为0.117,P=0.1290.05。 2.通过解剖实验测得两踝最高点连线中点定位针在踝穴顶部中点偏外侧,平均1.17mm,足背动脉在踝关节线处恰经过(口母)长伸肌腱下方,位于踝穴顶部中点偏内侧,其外径平均2.46mm,距离钢针距离平均2.53mm,距离踝穴顶部中点平均1.36mm,(口母)长伸肌肌腱在踝关节线处宽7.72mm,外缘距离踝穴中点平均为0.21mm,距离钢针1.38mm。
[Abstract]:Objective to study the exact position of the midpoint of ankle mechanics, and to measure and compare the external edge of extensor tendon and the dorsal artery of foot by X-ray and autopsy of the cadavers of ankle joint.In order to determine the closest anatomic mark to the middle point of ankle mechanics, it provides the basis for the accurate positioning of the lower limb force line during total knee arthroplasty.Materials and methods1.128 cases of adults without ankle disease and malformation, with an average age of 43.9 years (180-60 years old), were marked MCAA at the midpoint of the medial lateral malleolus line and the intersection point of the dorsal foot artery and the striae of the ankle respectively. The standard anterior and posterior images of the ankle joint were taken by CR-X line machine.The distance between the midpoint of the projection of the talus item at the transverse striation of the ankle and the projection of the above two mark points, the distance between the projection of Agnum M' and the distance between the two markers, was measured on the computer. The center of the projection was C', and the distance overlapped with it was zero, and the distance on the outer side of the talus was positive.At the inner side of the negative value, record the results.2.Kirschner's needle was used to locate the midpoint of the inner and lateral malleolus in 24 adult lower extremity anatomical specimens of 17 males and 7 females.The distance and relationship between Kirschner's needle and the middle point of the top of talus and the outer edge of the dorsalis pedis artery and extensor longus tendon were measured.To measure the external diameter of dorsalis pedis artery and the distance between the medial and outer malleolus, the transverse diameter of extensor longus tendon in the plane of tibiotalar joint line, and the distance between the length of extensor tendon and the inner and outer ankle joint.The anatomical relationship between the artery and the dorsal foot artery was observed.Results:1.By means of radiologic method, 96 cases of projection M' of the midpoint of two ankle lines were detected on the radiographic images. 20 cases were located on the lateral side of the central point of the talus and 12 cases were located on the medial side of the point of the C' point, and 12 cases were located on the medial side of the C' point.2.Anatomical experiments showed that the midpoint of the midpoint on the top of the ankle point was located on the lateral side of the top of the ankle point, with an average of 1.17 mm. The dorsal foot artery passed just below the tendon of the long extensor muscle at the line of the ankle joint and was located at the medial side of the midpoint of the ankle point.The average external diameter was 2.46 mm, the distance from the needle to the needle was 2.53 mm, the distance to the midpoint of the ankle point was 1.36 mm, the width of extensor longus tendon was 7.72 mm at the ankle joint line, the average distance from the outer edge to the middle point of the ankle point was 0.21 mm, and the distance to the needle was 1.38 mm.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2005
【分类号】：R816.8;R322

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