摘要
目的:测量跟骨轴长、宽度和高度,探讨螺钉入路及固定点,为微创内固定技术治疗跟骨骨折治疗提供解剖学依据。方法:260份无跟骨损伤的轴位及侧位X线片和120份无跟骨损伤的CT片,在X线片及CT上做其纵轴长度为跟骨轴长L,取其中点做跟骨纵轴的垂线为宽度W。在跟骨侧位片上,从跟骨丘部顶点向下做垂线,于跟骨下缘相交的距离为跟骨丘部高度H。成人跟骨标本60个,测量跟骨轴长、宽度、高度;跟骨结节入钉点区域及该部位入钉固定跟骨前部、后关节面、载距突。结果:X线片跟骨测量跟骨轴长平均为(68.02±8.24)mm,宽度平均为(30.86±6.26)mm,高度平均为(40.66±7.48)mm;CT片跟骨测量跟骨轴长平均为(67.82±6.38)mm,宽度平均为(30.16±4.62)mm,高度平均为(40.02±3.34)mm;跟骨标本测量跟骨轴长平均为(69.12±7.32)mm,宽度平均为(32.18±5.34)mm,高度平均为(42.02±6.62)mm;各数值均为非正态分布,因此未进行均数的显著性检验。跟骨各数值之比:宽度/轴长为0.45,高度/轴长为0.60,宽度/高度为0.76。跟骨结节外侧区域入钉可以牢固地与跟骨前部、后关节面及载距突固定为一体。结论:跟骨宽度、高度与轴长的测量可为跟骨骨折治疗及手术器械研制提供解剖学参数,通过跟骨结节外侧区域入钉可以固定跟骨前部、后关节面、载距突为一体,可有效维持跟骨的外形。
Objective： To measure the width, height and length of calcaneus, explore the screw approach and fixation point, and provide parameters for the treatment of fracture of calcaneus. Methods： 260 X-ray films of calcaneus taken from axial and lateral view and 120 CT films of calcaneus without the injury of calcaneus were selected. The axial line of calcaneus on films was taken as the length of it（L）, as well the vertical line from the middle point of L to calcaneus as its width （W）. On the lateral X-ray, the distance from the tip point of central crest of calcaneus to the inferior margin of it was taken as calcaneal height （H）. 60 calcaneal specimens were used to measure the width, height and length of calcaneus. Results： On the X-ray films, calcaneal length was（68.02±8.24）mm, width （30.86±6.26）mm, and height （40.66±7.48）mm, on CT film, calcaneal length was （67.82±6.38）mm, width （30.16±4.62）mm, andheight （40.02±3.34）mm, and the length of calcaneal specimens was（68.02± 8.24）mm, width （30.86±6.26）mm and height （40.66±7.48）mm. The ratio of width and length was 0.45, that of height and length 0.60, of width and height 0.76. Conclusions： The outcome of calcaneal width, height and length can provide anatomic parameters of calcaneus for the treatment of calcaneal fracture. From the outside of the calcaneal tubercle, the international fixation of screw will fix firmly the tubercle, anterior part of calcaneus and sustentaculum tali, which is important for maintaining integrity of calcanues.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2007年第5期521-524,共4页
Chinese Journal of Clinical Anatomy
基金
广州市医药卫生科技成果转化推广项目(2005-ZH-01)
关键词
跟骨
骨折
内固定
微创
解剖
calcaneus
fracture
ntemal fixation
minimal invasive
anatomy
作者简介
颜登鲁（1971-），男，甘肃兰州人，副主任医师，医学博士，主要从事骨科临床及科研工作，Tel：（020）81292150
