腓骨不同部位切除对胫腓下联合形态改变的研究

Research on shape changes of tibiofibular syndesmosis following fibula resected from different positions.

目的分析腓骨不同部位切除对胫腓下联合形态的不同影响，探讨腓骨截取的最佳部位，为临床科学合理地应用腓骨提供理论依据。方法选取10具身高172～176cm、腓骨长约36cm的成人男性防腐尸体，制作20例成人小腿-足踝标本，分别测量、分析腓骨完整时和在腓骨下1／6、下1／4、下1／3、1／2点处分别向近侧切除10cm长腓骨情况下对胫腓下联合形态的改变。结果腓骨完整时，胫腓下联合移位值为（0．30±0．10）mm；在腓骨下1／6点处向近侧切除10cm长腓骨后，胫腓下联合移位值与腓骨完整时相比变化显著，为（0．54±0．20）mm（P〈0．05）；在腓骨1／2点处向近侧切除同样长腓骨后，胫腓下联合移位值与腓骨完整时相比变化不明显，为（0．31±0．20）mm（P〉0．05）。结论腓骨最佳截取部位在腓骨1／2点处的近侧段。

Objective To investigate the different effects of different resection position of fibula on shape of tibiofibular syndesmosis, and explore the best position of cut fibula, providing reference for clinical surgeon to use fibula reasonably. Methods Ten adult male cadaveric specimens 172-176 cm long were used for 20 shanknkle specimens. 10 cm long fibula was cut proximally at the lower point 1/6, lower point 1/4, lower point 1/3, middle point 1//2 respectively,which was compared with the normal one to analyze the changes of shape of tibiofibular syndesmosis. Results Normally, the distance of tibiofibular syndesmosis was （0.30 ± 0.10） ram. Under the condition of cut at the lower point 1/6, the distance of tibiofibular syndesmosis was enlarged [ （0.54 ± 0.20） mm] （ P 〈 0.05 ）. In contrast,under the condition of cut 10 cm long fibula proximally at the middle point 1/2 ,the distance of tibiofibu- lar syndesmosis had little effect [ （0.31 ± 0.20） mm ] （ P 〉 0.05 ）. Conclusion The best resection position of fibula is in the proximity of the fibula at the point 1/2.