距跟关节的内稳定结构和不稳矫正

Intra stability mechanics of talocalcaneal joint and surgical problems

目的研究距跟关节的内稳定结构和不稳定的矫正办法。方法观察７只尸体足和４０副距跟骨的距跟关节（距下关节）。结果发现维护距跟关节的内在稳定机制有三：（１）距跟关节的鞍状镶嵌作用；（２）短粗有效的距跟骨间韧带；（３）有限的活动度。对距跟骨间韧带的位置、形态和三束韧带纤维等特点进行运动学观察。结论发育障碍和病损、破坏距跟关节的稳定机制是造成该关节不稳定的主要原因。

Objective To study the inter stability mechanics of talocalcaneal joint and correction techniques for instability. Methods Observation of the talocalcaneal joint(subtalar joint) was carried out on cadaver feet specimens and 40 pairs of talus and calcaneus with intact talocalcaneal joints. Results There were three importent parts to defend the inter stabilization of the talocalcaneal joint, including the saddle inlay effect between the subtalar joints, the short and thick talocalcaneal interosseous ligaments, and the limited articular motion. The position, pattern and the kinematical analysis of the three bundle of the fibrous ligament were studied. Conclusion The important reasons of articular instabilization were joint dysplasia,injury and disorder,which damaged the stability mechanics of the subtalar articulation. The technique of the subtalar arthrodesis was modified according to 12 patients in recent years and the result was satisfactory.