三角骨与后踝疼痛的关系

OsTrigonumandItsRelationshipwithRetrocalcanealPain

距骨后三角骨损伤，是造成后踝疼痛的主要原因之一，在芭蕾舞演员中并不少见。自１９７３～１９８２年对８例１４足在局麻下做了三角骨切除术，于跟腱外或内侧做竖切口，长２．５～３ｃｍ，历时２０～３０分钟。术后４周开始训练，６～８周恢复正常练功。随访０．５～１４年，效果满意。１９８４年对国内、外专业芭蕾舞女演员３６例６３个立脚尖足侧位Ｘ线片进行了研究，发现距后三角骨的有无及大小与胫跟角有密切关系。无三角骨或三角骨＜０．５ｃｍ，则胫跟角小，后踝无或轻微痛。立脚尖时，跟骨立度高。三角骨＞０．５ｃｍ，则胫跟角大，后踝明显疼痛及压痛。立脚尖时，跟骨立度低，影响技术的发挥，建议手术治疗。

Injuryoftheostrigonumwhichislocatedattheposterioraspectofthetalus,isoneoftheimportantfactorscausingretrocalcanealpain.TheconditionisnotuncommonamongtheBaletdancersasaresultoftheirspecialfeaturesofphysicalexertionsduringtheirperfor-mance.Theauthorsreported8cases(14feet)ofostrigonuminjuriesoccurredinBaletdancersencounteredduring1973～1982.The8cases(14feet)werealtreatedwithsurgerygivingsatis-factoryresults.TheauthorsalsoreviewedtheX-rayfilmsontiptoepositionsof36Baletdancers(63X-raypictures),andmeasuredthesizeofostrigonumandtibial-calcanealangle.Itwasfoundthat,therewasaclosecorrelationwiththepresenceandabsenceof,aswelasthesizeofostrigonumwiththemagnitudeofthetibial-calcanealangle.