踝关节内侧韧带的解剖结构特点及其临床意义

The characteristic of anatomical structures and clinical significance of the deltoid ligament

目的观察踝关节内侧韧带解剖结构特点,为临床微创修复踝关节内侧韧带手术提供解剖学基础。方法剥离解剖8例男性成人无病变下肢标本,对踝关节内侧韧带进行形态学观察,采集相关数据并进行统计学分析。结果踝关节内侧韧带分深、浅两层：浅层韧带束从内踝前侧至后侧分为胫舟韧带（长18.22~26.14 mm）、胫弹簧韧带（长6.24~10.40 mm）、胫跟韧带（长10.32~14.36 mm）和胫距后韧带浅层（长8.32~13.52 mm）。深层结构包括胫距前韧带（长11.32~15.62 mm）和胫距后韧带深层（长10.22~12.60 mm,宽6.72~9.84 mm,厚1.72~2.24 mm）。结论依据踝关节内侧韧带的走行有助于分辨其组成层数及束数,掌握踝关节内侧韧带的解剖特点,有利于设计合理的手术方案。

Objective To observe the anatomical structures of the medial ankle ligament, and provide anatomical basis for the clinical minimally invasive repair of the medial ankle ligament. Methods Morphological observation of the medial ankle ligament through peeling and dissecting 8 cases of adult male corpses without pathological changes was made, and relevant data were collected and statistical analysis was made. Results The deltoid ligament has superficial and deep layers with up to 6 different bands. From anterior to posterior, the superficial layer consisted of the following： tibionavicular ligament （length 18.22~26.14 mm）, the tibiospring ligament （length 6.24~10.40 mm）, tibiocalneal ligament （length 10.32~14.36 mm） and superficial posterior tibiotalar ligament （length 8.32~13.52 mm）. While the deep layer consisted of the anterior tibiotalar ligament （length 11.32~15.62 mm） and the deep posterior tibiotalar ligament （length 10.22~12.60 mm, width 6.72~9.84 mm, thickness 1.72~2.24 mm）. Conclusions It is helpful to distinguish the components and bundles according to the shape of the medial ankle ligament. Profound knowledge of the anatomical characteristic of the medial ligament can facilitate a good planning of surgical program.