摘要
目的对踝关节深层胫距后韧带(dPTTL)进行解剖学和MRI观测,为深层胫距后韧带损伤后的诊断及修复重建提供依据。方法 34例成人尸体踝关节标本,分别测量dPTTL的长度、宽度、厚度,观察其在踝关节不同体位下的松弛-紧张变化规律,另选取我院无外伤史的36例成人踝关节MRI,对dPTTL的影像学表现进行观测。结果 dPTTL的长度为(13. 6±2. 8) mm;胫骨附着点处的宽度为(8. 6±1. 2) mm、厚度为(5. 1±1. 8) mm;中间处的宽度为(10. 3±2. 8) mm、厚度为(8. 3±1. 6) mm;距骨止点处的宽度为(12. 4±2. 3) mm、厚度为(10. 8±2. 1) mm; dPTTL在踝关节跖屈位、中立位时均为松弛状态,踝关节背伸10°左右时为紧张状态,dPTTL在踝关节MRI中出现率100%,在冠状位及横断位MRI能清晰显示。结论踝关节MRI能为dPTTL的损伤提供重要的诊断及治疗依据,修复重建踝关节深层胫距后韧带时,应该参照解剖学数据,综合考虑其长宽厚以及松紧变化规律等因素,从而提高修复重建的效果。
Objective The anatomical and MRI observations of the dPTTL of the ankles were performed to provide a basis for the diagnosis and reconstruction of the dPTTL injury.Methods The length,width,thickness of dPTTLs in ankle of 34 adult cadavers were measured,relaxation-tension variation of dPTTLs were observed and measured,the MRI of adult ankle joint in 36 cases without trauma history in our hospital were selected and the imaging findings of dPTTL were observed.Results The mean length of dPTTL was(13.6±2.8)mm;the mean width of tibial attachment of dPTTL was(8.6±1.2)mm,and the mean thickness was(5.1±1.8)mm;the mean of the middle of dPTTL was(10.3±2.8)mm,and the mean thickness was(8.3±1.6)mm;the mean width of talus attachment of dPTTL was(12.4±2.3)mm,and the mean thickness was(10.8±2.1)mm;dPTTL was relaxed state when the ankle plantarflexion and neutral position,however,dPTTL was tension when ankle dorsiflexion about 10°.The incidence of dPTTL in the ankle joint MRI was 100%,and the dPTTL can be clearly displayed in the coronal and axial images.Conclusion Ankle joint MRI can provide important diagnostic and therapeutic basis for dPTTL injury.When repair and reconstructe dPTTL of ankle,the anatomical data should be consulted,the length,width,thickness of dPTTL and relaxation-tension variation of dPTTL were considered to improve the effect of repairment and reconstruction.
作者
张程
郑国涛
曹希武
谢晨学
吴帅
王玉杰
边劲松
ZHANG Cheng;ZHENG Guo-tao;CAO Xi-wu;XIE Chen-xue;WU Shuai;WANG Yu-jie;BIAN Jin-song(Department of Orthopaedics Cangzhou People's Hospital Affiliated to Southern Medical University,Cangzhou Hebei 061000,China)
出处
《局解手术学杂志》
2019年第2期95-98,共4页
Journal of Regional Anatomy and Operative Surgery
作者简介
通信作者:边劲松,E-mail:bjs0183@163.com.
