本文關(guān)鍵詞： 踝關(guān)節(jié)外側(cè)副韌帶 前距腓韌帶 跟腓韌帶 解剖 變異系數(shù)　出處：《中國運(yùn)動(dòng)醫(yī)學(xué)雜志》2017年06期 　論文類型：期刊論文

【摘要】：目的:通過對人體踝關(guān)節(jié)標(biāo)本的定量解剖,明確踝關(guān)節(jié)外側(cè)副韌帶相關(guān)形態(tài)參數(shù)及其起止點(diǎn)足印區(qū)至各解剖標(biāo)志的距離,為踝關(guān)節(jié)外側(cè)副韌帶重建手術(shù)提供解剖學(xué)依據(jù)。方法:共選取19例下肢尸體標(biāo)本,對踝關(guān)節(jié)外側(cè)副韌帶進(jìn)行精細(xì)解剖觀察并對相關(guān)參數(shù)如長度、寬度、厚度及其起止點(diǎn)至各解剖標(biāo)志的距離進(jìn)行定量測量。結(jié)果:19例人體下肢標(biāo)本中,前距腓韌帶(ATFL)平均長度為23.1±2.98 mm,其中單束8例(42.1%),雙束11例(57.9%)。前距腓韌帶腓骨起點(diǎn)至腓骨前部結(jié)節(jié)平均距離(AA)為17.1±3.00 mm,至腓骨隱匿結(jié)節(jié)(AO)平均距離為5.1±1.69 mm,至腓骨尖(AT)平均距離為14.1±2.86mm,前距腓韌帶距骨止點(diǎn)至距骨上下關(guān)節(jié)面的平均距離分別為11.4±2.25 mm及18.4±2.30 mm,至距骨前外軟骨面的平均距離為4.8±1.42 mm。跟腓韌帶(CFL)平均長度為31.4±3.55 mm,跟腓韌帶腓骨起點(diǎn)至前距腓韌帶腓骨起點(diǎn)的平均距離為6.4±2.55 mm,跟腓韌帶與前距腓韌帶間夾角為116.6±12.69°,跟腓韌帶跟骨止點(diǎn)至跟骨外側(cè)結(jié)節(jié)(CP)平均距離為15.4±2.86 mm,至跟骨后上緣(CC)平均距離為13.9±2.46 mm,至距下關(guān)節(jié)面(CS)平均距離為15.2±3.21 mm。以變異度衡量各解剖標(biāo)志相對穩(wěn)定性結(jié)果如下:ATFL腓骨止點(diǎn)AA(17.54%)AT(20.28%)AO(33.14%),CFL跟骨止點(diǎn)CC(17.70%)CP(18.57%)CS(21.1%)。結(jié)論:通過解剖研究發(fā)現(xiàn)踝關(guān)節(jié)外側(cè)副韌帶形態(tài)參數(shù)及起止點(diǎn)至各解剖骨性標(biāo)志的距離存在一定的變異性,為臨床上解剖重建踝關(guān)節(jié)外側(cè)副韌帶治療慢性踝關(guān)節(jié)不穩(wěn)定提供了解剖依據(jù)。
[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 鹵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 鹵3.00 mm. The average distance between AOA and ATA was 5.1 鹵1.69mm and 14.1 鹵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 鹵2.25mm and 18.4 鹵2.30 mm, respectively. The average distance to the anterior outer surface of talus was 4.8 鹵1.42 mm. the average length of CFL was 31.4 鹵3.55 mm. The average distance between fibular origin and fibular origin of calcaneus fibular ligament was 6.4 鹵2.55 mm, and the angle between calcaneal ligament and anterior talofibular ligament was 116.6 鹵12.69 擄. The average distance between calcaneal insertion point and lateral calcaneal tubercle was 15.4 鹵2.86mm and 13.9 鹵2.46mm respectively. The average distance to CSS is 15.2 鹵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.
【作者單位】： 復(fù)旦大學(xué)附屬華山醫(yī)院運(yùn)動(dòng)醫(yī)學(xué)科;
【基金】：國家自然科學(xué)基金面上項(xiàng)目(8157090042)
【分類號(hào)】：R322.7;R687.4
【正文快照】： 踝關(guān)節(jié)扭傷占所有運(yùn)動(dòng)損傷的10%~15%[1,2],即使通過及時(shí)治療,仍有近30%左右的踝關(guān)節(jié)扭傷可能發(fā)展為慢性踝關(guān)節(jié)不穩(wěn)定[3]。踝關(guān)節(jié)扭傷時(shí)的主要損傷結(jié)構(gòu)是踝關(guān)節(jié)外側(cè)副韌帶,包括前距腓韌帶(anteriortalofibular ligament,ATFL)、跟腓韌帶(calcaneofibularligament,CFL)、后距腓

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