跟骨距骨桥的诊断及形态分型

Diagnosis and morphological pattern of talocalcaneal bridge

目的:探讨跟距骨桥的形成机制与解剖形态特点。方法:本组25例均摄正侧位X线片,其中4足行CT横断扫描,10足行斜位X线点片,单侧21例,双侧4例,共有跟距骨桥29足。结果:关节增生硬化型:共17足,X线平片上可见跟、距关节内侧的骨性突起,跟、距骨的异常骨块表面光滑、致密,距骨内结节增大,呈帽状覆盖于异常增大的载距突上,跟、距两骨间有一间隙。CT片可见跟、距关节间隙变窄,边缘变尖、硬化、翘起,尤以跟、距后关节为著。关节融合型:共10足,在X线平片及CT上可见跟、距关节间隙消失,跟、距骨间呈骨性连接。骨桥型:2足,跟、距关节间隙存在,跟距两骨间有一带状骨影相连,正位片呈拱桥状弧形内突。结论:跟距骨桥的X线形态分型,对本病的临床诊断、治疗具有指导意义。

Objective：To detect the mechanism of talocalcaneal bridge （or coalition） and the manifestation of it＇ s anatomy and morphology. Methods： All of 25 cases （ 11 males, 14 females） were examed by anterioposterior view and lateral view of plain films in 29 talocalcaneal joints, CT scanning in 4 joints, focused oblique iilms in 10 joints.Results：In osteosclerotic joint pattern （17 joints）, bony bar can be showed at medial facet of talocalcaneal joint in phin film, also compact and smoothing at the surface, and enlargement of medial node of talus, cap-like on the large sustentaeulum tali, leaving a joint space between them,, and showing narrowly in joint space and marginal spur and sclerosis, especially at posterior facet; in fusion pattern （ 10 joints）, disappearance and bony connection of joint space were showed between talor and calcaneus; in bony bridge pattem （2 joints）, talocaleaneal joint space was reserved, showing band-like bony dement between those two bones, like bridge with medial are in AP view of plain film. Conclusion：The pattem and the manifestation of talocalcaneal bridge in plain film can play helping and important role in the diagnosis and clinical treatment.