足韧带的解剖学研究及其临床意义

Anatomic study and clinical significance of foot ligaments

目的:研究足韧带的解剖学特点,探讨其临床意义。方法:30侧成人足标本解剖观测各韧带起至、走行和比邻,分析其作用。结果:距舟背侧韧带分为内、外两束。楔舟背侧韧带分为内、中、外、斜4束。足横弓和纵弓交汇处为足底最凹点,足底长短韧带、腓骨长肌腱、胫骨后肌腱为"外三角",楔舟足底韧带、楔骰足底韧带、跟舟足底韧带为"内三角",维系该凹点。跟舟足底韧带承托距骨头部,是将踝压力分向第1跖骨头和足跟的首要韧带。各楔骨、楔骰骨间韧矢状面上都位于关节前侧,不规则形,质地强韧,维系足横弓。结论:足部韧带分为足背、足底和骨间3个系统,结构复杂,其功能及其在创伤外科中的意义有待深入研究。

Objective： To study anatomic characteristics of foot ligaments and explore its clinic significance. Methods： Thirty adult specimens of feet were dissected in this study. The origin and insertion, course and the closely structures of different foot ligaments were observed and measured, and then the functions of ligaments were analyzed. Results： The dorsal talonavicular ligament divided into medial and lateral bundles, and the dorsal cuneonavicular ligament into four bundles： the medial, intermediate, lateral and oblique bundles. The crossing site of the longitudinal and transverse arcs was the most concave point. For maintaining this concave point, the long and short plantar ligaments, the fibularis longus tendon and the tibialis posterior tendon formed the ＂outer triangle＂, while the plantar cuneonaviculart, the plantar cuneocuboid and the plantar calcaneonavicular ligaments formed the ＂inner triangle＂. The plantar Calcaneonavicular ligament was the key ligament for beating and dispersing press from the talus head into the first metatarsal head and heel. The interosseous ligaments between the cuneiform bones and the cuboid located anteriorly at the joint surfaces of the bones. Strongly and irregularly, the interosseous ligaments maintained the transverse arc. Conclusions： Foot ligaments could be classified into three systems： the dorsal, plantar and interosseous ligaments. Foot ligaments should be highlighted in the trauma surgery for their complicated structures and important functions.