踝关节外侧韧带的解剖学观测及其临床意义

Anatomical evaluation and clinical significance of lateral ankle ligament

目的:测量踝关节外侧距腓前韧带、跟腓韧带的相关解剖学参数,为临床踝关节外侧韧带重建提供解剖学依据。方法:26例足部标本,解剖测量距腓前韧带、跟腓韧带的长度,插入角度,止点宽度及与骨性结构的毗邻关系。结果:标本距腓前韧带平均长度为(20.08±2.16)mm,腓骨侧止点宽为(8.75±1.8)mm,距骨侧止点宽度为(9.26±1.34)mm;影像学测量距腓前韧带的插入角度:足中立位侧位与腓骨长轴成角81°±11°,正位与腓骨长轴成角67°±7°。与外科标志的毗邻关系:距腓前韧带在距骨止点与距骨颈上缘的垂直距离为(12.92±0.93)mm,距腓前韧带腓骨侧止点与腓骨尖的距离为(11.44±0.61)mm。跟腓韧带平均长度为(32.72±9.17)mm,跟骨侧止点宽为(5.08±0.77)mm,腓骨侧止点宽为(4.76±0.62)mm。影像学的韧带插入角度:足中立位侧位上与腓骨长轴成角47°±16°。与外科标志的毗邻关系:跟腓韧带腓骨侧止点与腓骨尖的距离(3.74±0.55)mm;跟腓韧带跟骨侧止点与距下关节面的垂直距离(12.62±2.08)mm。结论:踝关节距腓前韧带、跟腓韧带长度及止点处宽度较为恒定,跟腓韧带插入角度变异较大。在进行踝关节外侧韧带重建时,需考虑其解剖学特点。

Objective ：To measure anatomy of anterior talofibular ligament （ATFL） and calcaneofibular ligament （CFL） and their relationship to adjacent osseous structures, in order to provide anatomical reference to surgical procedures. Methods： Twenty-six human ankle cadavers were used in this study. The mean value of length, insertion width, insertion angle and distance to adjacent osseous structures were measured. Results： The lengths of ATFL and CFL were （20.08 ±2.16） mm and （32.72 ±9.17） mm. The width of ATFL were （8.75 ± 1.8 ） mm （proximal） and （ 9.26 ± 1.34） mm （distal） respec- tively. The distanee of distal ATFL footprint to the upper-surface of talus neck were （ 12.92 ± 0.93 ） ram, the distance of proximal ATFL footprint to fibular tip were （ 11.44 ±0.61 ） mm. The width of CFL were （4.76 ±0.62） mm （proximal） and （5.08 ±0.77） mm （distal） respectively. The distance of proximal CFL footprint to fibular tip were （3.74 ± 0.55 ） mm, The distance of distal CFL footprint to the surface of subtalar joint were （ 12.62 ± 2.08 ） mm. The insertion angle with fibular axis in lateral view of ATFL and CFL were 81°± 11°and 47° ±16° respectively. ATFL in anterioposterior view had 67° ±7° angle with fibular axis. Conclusion： The length and width of ATFL and CFL were relatively constant. The lateral insertion angle was relatively with large variation. These data may provide reference for reconstruc- ting lateral ankle ligaments.