本文選題：內(nèi)踝 + 內(nèi)踝角��； 參考：《中南大學(xué)》2007年碩士論文

【摘要】： 目的對(duì)內(nèi)踝進(jìn)行解剖學(xué)測(cè)量，為臨床手術(shù)方法和內(nèi)固定的選擇，術(shù)中安全而準(zhǔn)確地置入內(nèi)固定以及設(shè)計(jì)內(nèi)踝定位導(dǎo)向器提供解剖學(xué)依據(jù)。 方法選取中南大學(xué)湘雅醫(yī)學(xué)院人體解剖教研室完整成人脛骨骨性標(biāo)本共20對(duì)，男女各10對(duì)，，左右配對(duì)；選取中南大學(xué)湘雅三醫(yī)院放射科標(biāo)準(zhǔn)內(nèi)踝正側(cè)位X片20例，男女各10例，左右配對(duì)，觀察內(nèi)踝的大體形態(tài)。 選取七條線：1、脛骨前面觀有五條線：①脛骨的中軸線L_1；②經(jīng)脛骨下端關(guān)節(jié)面的切線L_2(平行脛距關(guān)節(jié)面)；③內(nèi)踝外側(cè)面的切線L_3；④內(nèi)踝內(nèi)側(cè)面的切線L_4；⑤經(jīng)內(nèi)踝尖與脛距關(guān)節(jié)面的平行線L_5；2、脛骨內(nèi)側(cè)面觀有兩條線：⑥脛骨下端關(guān)節(jié)面水平內(nèi)踝前后緣的連線L_6(即mn連線)；⑦經(jīng)內(nèi)踝下緣與脛距關(guān)節(jié)面的平行線L_7。 選取三個(gè)點(diǎn)：①內(nèi)踝尖o；②脛骨下端關(guān)節(jié)面水平內(nèi)踝最前緣點(diǎn)m：③脛骨下端關(guān)節(jié)面水平內(nèi)踝最后緣點(diǎn)n。 通過選取以上的線和點(diǎn)獲得以下的內(nèi)踝參數(shù)：①M(fèi)A(由線L_1和L_3相交形成的銳角，即內(nèi)踝的內(nèi)翻角，簡(jiǎn)稱內(nèi)踝角)；②TA(由線L_2和L_3相交形成的銳角，即脛骨角)；③內(nèi)踝的上下徑即高度H(線L_2和L_5之間內(nèi)踝的實(shí)際長(zhǎng)度即o點(diǎn)到線mn的垂直距離)；④內(nèi)踝上端寬度W_上(即在脛骨下端關(guān)節(jié)面水平內(nèi)踝前后緣之間的距離mn)；⑤內(nèi)踝下端寬度W_下(線L_7在內(nèi)踝前后緣之間的距離)；⑥內(nèi)踝上端厚度T_上(內(nèi)踝根部處的厚度)；⑦內(nèi)踝下端厚度T_下(內(nèi)踝尖基底部處的厚度)；⑧內(nèi)踝中線厚度T(內(nèi)踝一半高度處的厚度)。 在骨性標(biāo)本上完成對(duì)內(nèi)踝高度H、內(nèi)踝上端寬度W_上、內(nèi)踝下端寬度W_下、內(nèi)踝上端厚度T_上、內(nèi)踝下端厚度T_下和內(nèi)踝中線厚度T的測(cè)量，在X線片上完成對(duì)內(nèi)踝角MA的測(cè)量。 結(jié)果1．側(cè)面觀從上到下內(nèi)踝逐漸變窄，近似于一個(gè)倒立的梯形。2．從上到下內(nèi)踝的厚度逐漸均勻的變薄，但變化不大。3．通過在骨性標(biāo)本上和在X線片上對(duì)內(nèi)踝左右兩側(cè)參數(shù)分別進(jìn)行測(cè)量比較差異無統(tǒng)計(jì)學(xué)意義(p＞0.05)。4．分別在男女骨性標(biāo)本上對(duì)內(nèi)踝高度H、內(nèi)踝上端寬度W_上、內(nèi)踝下端寬度W_下、內(nèi)踝上端厚度T_上、內(nèi)踝下端厚度T_下和內(nèi)踝中線厚度T進(jìn)行測(cè)量比較差異有統(tǒng)計(jì)學(xué)意義(p＜0.05)。5．分別對(duì)男女X線片上內(nèi)踝角MA進(jìn)行測(cè)量比較差異無統(tǒng)計(jì)學(xué)意義(p＞0.05)。6．通過在X線片上測(cè)量可以發(fā)現(xiàn)存在一相對(duì)恒定的內(nèi)踝角，它有一個(gè)相對(duì)穩(wěn)定的變化范圍。 結(jié)論1、本研究通過對(duì)內(nèi)踝的解剖學(xué)研究，提出了內(nèi)踝相關(guān)參數(shù)的測(cè)量方法，特別是提出了內(nèi)踝角的概念。 2、獲得內(nèi)踝相關(guān)參數(shù)的可靠解剖學(xué)數(shù)據(jù)，為內(nèi)踝骨折內(nèi)固定的選擇以及術(shù)中準(zhǔn)確安全地置入內(nèi)固定提供指導(dǎo)，并為下一步設(shè)計(jì)內(nèi)踝骨折手術(shù)的定位導(dǎo)向器提供解剖學(xué)依據(jù)。
[Abstract]:Objective to measure the anatomy of medial malleolus and provide anatomic basis for the choice of clinical operation and internal fixation, the safe and accurate insertion of internal fixation and the design of medial malleolus positioning guide. Methods A total of 20 pairs of intact adult tibial bone specimens were selected from the Department of Human Anatomy, Xiangya Medical College, Central South University, 10 pairs of male and female pairs, and 20 cases of standard medial ankle lateral position X ray, 10 cases of male and female, in the Department of Radiology, Xiangya third Hospital of Central South University. Pairing left and right to observe the gross shape of the medial malleolus. Select seven lines: 1, 5 lines in front of tibia: 1 tibia central axis L1T 2 through the tibia distal articular surface tangent line L2 (parallel tibial talus articular surface) 3 medial malleolus lateral side tangent line L3M4 medial malleolus side tangent L4; (5) parallel line L5D through the medial malleolus and tibial talus articular surface, and two lines at the medial side of tibia: 1 / 6, L6 (mn line), L6 (mn line) through L7 parallel line between medial malleolus and tibial talus articular surface. Select three points: 1 at the tip of the medial malleolus and 2 at the level of the articular surface of the lower end of the tibia. The point of the anterior edge of the medial malleolus at the lower end of the tibia is m: 3. By selecting the above lines and points, the following parameters of the medial malleolus: 1MA (acute angle formed by the intersection of line L1 and LSP 3, I. E. the inner malleolus angle, abbreviated as the medial malleolar angle) were obtained, and the 2TA (acute angle formed by the intersection of line L2 and LSP 3, that is tibia angle) was obtained. (3) the upper and lower diameter of the medial malleolus is the height H (the actual length of the medial malleolus between L2 and LST5 is the vertical distance from o point to line mn) 4 the width of the upper end of the medial malleolus W _ above (that is, the distance between the anterior and posterior sides of the medial malleolus at the lower articular surface of the tibia). (5) the width of the lower end of the medial malleolus (the distance between the anterior and posterior margin of the medial malleolus) and the thickness of the upper end of the medial malleolus (the thickness of the root of the medial malleolus), and the thickness of the lower end of the medial malleolus (the thickness of the base of the medial malleolus); Medial malleolus thickness T (thickness at half the height of medial malleolus). The height of the medial malleolus (H), the width of the upper end of the medial malleolus (W _), the width of the lower end of the medial malleolus (W _), the thickness of the upper end of the medial malleolus (T _), the thickness of the lower end of the medial malleolus (T _) and the thickness of the median line of the medial malleolus (T _) were measured on the bone specimen. Results 1. The lateral view gradually narrowed from the top to the bottom of the medial malleolus, which was similar to a inverted trapezoidal shape. The thickness of the medial malleolus from the top to the bottom became thinner and more evenly. There was no significant difference in the parameters of the left and right sides of the medial malleolus between the bone specimens and the X-ray films (p > 0.05) .4.The height of the medial malleolus Hand the width of the upper end of the medial malleolus were measured on the male and female bone specimens respectively. The width of the lower end of the medial malleolus W _, the thickness of the upper end of the medial malleolus T _, There was significant difference in the thickness of the medial malleolus between the lower end of the medial malleolus and the middle line of the medial malleolus (p < 0.05). 5. There was no significant difference in the measurement of the medial malleolus angle between male and female X-ray films (p > 0.05) .6. On-chip measurements show a relatively constant angle of the medial ankle, It has a relatively stable range of changes. Conclusion 1. Based on the anatomical study of the medial malleolus, a method for measuring the parameters of the medial malleolus was put forward. In particular, the concept of medial malleolus angle was put forward. 2. The reliable anatomical data of medial malleolus related parameters were obtained, which provided guidance for the choice of internal fixation of medial malleolus fracture and the accurate and safe insertion of internal fixation during operation. It also provides anatomic basis for the design of positioning guide for medial malleolus fracture.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2007
【分類號(hào)】：R687.1;R322

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