外踝长度短缩时踝关节应力改变的研究

Effects of the shortened lateral malleolus on the stability of malleolus

目的:分析外踝长度短缩与踝关节稳定性的关系,探讨创伤性踝关节炎发生的生物力学机制。方法:选取8例新鲜冷冻尸体下肢,分别在外踝正常长度、短缩1/3、短缩2/3和短缩3/3的情况下,测量和分析胫距关节的接触面积和应力变化。结果:正常的胫距关节接触区呈三角形,外踝短缩后胫距关节接触区向外侧移位,胫距关节接触面积明显减小。胫距关节面平均应力明显增加,以向前、内、外侧压力增高最为显著,且应力随外踝短缩程度的加重而增加。结论:外踝正常长度是维持踝关节稳定性的重要指标。因此,在处理踝关节损伤时应尽可能恢复外踝的解剖长度。

Objective： To analyze the relationship between the shortened lateral malleolus and the stability of malleolus and to explore the biomechanism of traumatic ankle arthritis. Methods： Eight fresh frozen lower extremity specimens were used. At the condition of normal ,shortened 1/3 ,shortened 2/3 and shortened 3/3 length,the tibial astragaloid joint＇s area and pressure were measured. Results： The contact area of the normal tibial astragaloid joint analyzed by shapes of dyeing area looked like the triangle. For shortened lateral malleolus, the contact area of the tibial astragaloid joint moved outward and diminished, the average pressure of the tibial astragaloid joint increased obviously.Conclusions：The normal length of lateral malleolus play an important role in the stability of ankle,therefore, we should try our best to restore the length of the lateral malleolus during the operation.