跟骨载距突与其外侧壁关系的测量

MEASUREMENT OF ANATOMY OF CALCANEOUS SUSTENTACULUM TALI AND PARIES LATERALIS

目的研究跟骨载距突与其外侧壁的解剖关系,获得通过跟骨外侧壁固定载距突螺钉的安全通道。方法测量跟骨骨骼标本50副,确定跟骨外侧壁理想的进钉点和进钉角度方向。取30例防腐处理的足,根据测得数据钻入直径3.5mm的钢针,观察钢针在载距突的位置及其与后关节面关系。结果通过三臂形跟骨钢板的上臂以理想的进钉点和角度可以钻入直径4.0mm全螺纹钛钉两枚。其前点螺钉平均长度为41.84mm,与跟骨外侧面平均呈69.41°、与跟骨外侧面的底垂面平均呈22.67°;后点螺钉平均长度为42.28mm,与跟骨外侧面平均呈68.45°、与跟骨外侧面的底垂面平均呈20.79°;30足60枚钢针有2枚钻出跟骨后关节面,钻入安全率为97.67%。结论根据所测得的解剖数据可以确定通过跟骨外侧壁固定载距突螺钉的安全通道。

Objective To study the anatomy of calcaneous sustentaculum tail and paries lateralis, and confirm the safe fixation pathway for sustentaculum tall and paries lateraiis. Methods Fifty pairs of calcaneous specimen were measured to study the ideal site and direction of paries lateralis of calcaneous. Based on the data measured, two 3.5 mm diameter nails were drilled in to each of the 30 antiseptic sample feet. The position of the nail and its relationship with the post articular facet of calcaneous were observed. Results Two 4.0 mm diameter nails were drilled through the upper arm of three arm pattern calcaneous plate accord ing to the measured ideal site and direction. The screw length of prefixed point was 41.84 mm, the screw angle with paries lateralis was 69.41°, the screw angle with inferior verticular plane of paries lateralis was 22. 67°; the length of postfixed point was 42.28 mm, the angle with paries lateralis was 68.45°, the angle with inferior verticular plane of paries lateralis was 20.79°. Of the 60 nails drilled, two were drilled out of the post facies articularis of calcaneous, the accuracy rate was 97. 670%. Conclusion A safe pathway through paries lateralis for sustentaculum tall fixation could be decided based on the anatomic data.