下胫腓联合损伤韧带重建的生物力学研究

Biomechanical study of ligment reconstruct of distal tibiofibular syndesmosis injury

目的比较下胫腓联合损伤采用腓骨长肌腱在不同方向上进行重建的生物力学特性,为临床韧带重建提供科学依据。方法采用新鲜成人尸体踝标本6具,运用生物力学实验方法和压敏片技术,测量不同韧带重建方式的内外踝的应变、位移、胫距间负重面积、接触应力。结果在下胫腓前韧带及骨间韧带之间方向上斜向重建下胫腓在内外踝应变、位移、负重面积、接触压力方面均优于其他重建方式,具有显著性差异(P<0.05)。结论在下胫腓前韧带及骨间韧带之间方向上斜向重建下胫腓,既有利于增强生物力学性能,又有利于改善踝关节的稳定性,对临床上指导下胫腓联合损伤韧带重建方案有理论指导意义。

Objective To compare the biomechanic results of the figment reconstruct of the distal tibiofibular syndesmosis injury using peroneus longus tendon in different directions, in order to guide the figment reconstruction in clinic. Methods Six fresh specimens of adult ankles were used. The biomechanical test and the press-sensitive film technique were performed to measure the strain, the displacement of the medial and lateral malleoli, the load area and the contact pressure in each reconstruction. Results The test showed the ligment reconstructed at the oblique direction between the distal anterior tibiofibular ligment and the interosseous ligment was superior to other ways of reconstruction according to the displacement and the strain of the medial and lateral malleoli, the load area and the contact pressure. The differences of all these data were significant （ P 〈 O. 05 ）. Conclusion The ligment reconstruction in the oblique direction between the distal anterior tibiofibular ligment and the interosseous ligment can enhance the biomechanic property and improve the stability of the ankle. It is an excellet method for the ligment reconstruction of the distal tibiofibular syndesmosis injury.