距跟外侧韧带的解剖学研究及其临床意义

An anatomical study of the lateral talocalcaneal ligament and it’s clinical significance

目的观察距跟外侧韧带(LTCL)的解剖学特征并分型,为踝关节外侧面损伤的诊治提供解剖学依测量LTCL、CFL的长度及宽度,观察二者的关系,对LTCL划分解剖学类型。结果有12例标本出现LTCL,该韧带具有如下解剖学类型:(1) LTCL从CFL分出5例(10%),LTCL向前上方连于距骨或距腓前韧带的前下缘;(2) LTCL具有独立的起点4例(8%),此LTCL与CFL纤维方向几乎平行,向前上方连于距腓前韧带的下缘;(3) LTCL与CFL具有共同的起点3例(6%),但二者均为独立的韧带;(4) LTCL缺如38例(76%)。LTCL与CFL的宽度相比,差异有统计学意义(t=2.255,P=0.032)。结论对LTCL的解剖学分型,不仅是对既往研究的补充,也为踝关节外侧面损伤的影像学诊断及外科治疗提供基础支持。

Objective To clarify the morphological types of the lateral talocalcaneal ligament(LTCL).Methods Fifty adult lower limbs were dissected,and the parameters of LTCL,CFL were measured and then the types of LTCL were determined.Results Twelve cases presented LTCL and the specimens were classified into four types:(1) the LTCL was branching from the calcaneofibular ligament(CFL)in 5 cases;(2) the LTCL was independent of the CFL and ran parallel to the CFL in 4 cases;(3) the LTCL and the CFL originated from the same location,but the LTCL presented as an independent ligament in 3 cases.(4) the LTCL was absent in 38 cases. There was significant difference in the width between the LTCL and the CFL(t=2.255,P=0.032).Conclusion Knowledge of the features and classification of LTCL was useful for diagnosing and therapeutic procedures of the ankles.