“跖袖”的解剖学特点及临床意义

Anatomic features and clinical significance of the metatarsal cuff

目的:探讨跖袖的解剖学特点及临床意义。方法:对20只足的跖袖的构成特点进行应用解剖学观测及力学分析。结果:跖袖的构成复杂,其中收肌、展肌是维持前足横弓及籽骨系统动力平衡的关键因素,跖袖的动力平衡失调,特别是展肌与收肌通过籽骨系统导致的平衡失调是外翻形成的核心机制,在外翻畸形的发生中有着特殊的临床意义。结论:展肌与收肌移位吻合矫正外翻的新术式恢复了跖袖的正常解剖关系,重建前足横弓,恢复了前足的生理解剖结构及生物力学功能。

Objective： To explore anatomic features and clinical significance of the metatarsal cuff. Methods： Anatomic study and biomechanical analysis were performed on the metatarsal cuff of 20 normal feet. Results： The structures of the metatarsal cuff were complicated. The abductor and adductor hallucis were significant for maintaining arcus pedis transversalis and dynamic balance of sesamoids. The injury of biomechanical balance of the metatarsal cuff, especially that between abductor and adductor hallucis was main reason for the hallux valgns （HV）. Conclusions： Anastomosis of abductor hallucis and adductor hallucis can correct both hallux valgns and first metatarsus primus varus. At the same time, it is useful for relocating sesamoid system and reconstructing the transverse arch of the forefoot, as well recovering the normal anatomic structures and biomeehanieal function of the forefoot.