中国临床解剖学杂志 ›› 2021, Vol. 39 ›› Issue (2): 121-125.doi: 10.13418/j.issn.1001-165x.2021.02.001

• 应用解剖 •    下一篇

踝关节外侧韧带的形态学分型及临床意义

周云烽1, 徐达政2, 陈仲1, 姚伙生2, 张琮达1, 李卫平1, 沈慧勇1,3, 宋斌1   

  1. 1. 中山大学孙逸仙纪念医院骨科,  广州   510120;    2.中山大学中山医学院解剖学实验室,  广州   510080
    3. 中山大学附属第八医院骨科,  深圳   518033
  • 收稿日期:2020-05-05 出版日期:2021-03-25 发布日期:2021-04-07
  • 通讯作者: 宋斌,副主任医师,硕士研究生导师,从事运动医学临床及相关基础研究, E-mail: songbin3@mail.sysu.edu.cn
  • 作者简介:周云烽(1990-),男,湖北恩施人,在读博士,主要从事骨关节运动损伤与修复等方面的研究,E-mail: zhouyf27@mail2.sysu.edu.cn
  • 基金资助:
    广东省体育科技协同创新中心子课题(2019B11021 0004);广东省自然科学基金(2018A030313720,2020A1515011322)

Morphological classification of the lateral ankle ligaments and clinical significance

Zhou Yunfeng1, Xu Dazheng2, Chen Zhong1, Yao Huosheng2, Zhang Congda1, Li Weiping1, Shen Huiyong1,3, Song Bin1   

  1. 1.Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China; 2. Laboratory of Anatomy, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China; 3. Department of Orthopedics, Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen 518033, Guangdong Province, China
  • Received:2020-05-05 Online:2021-03-25 Published:2021-04-07

摘要: 目的 研究国人踝关节外侧韧带的形态学特点并探讨其临床意义。  方法 解剖43例踝关节标本,观察并记录外侧韧带的分束、走行、起止点及附着部位的纤维联系。  结果 所有标本都解剖出距腓前韧带(ATFL)和跟腓韧带(CFL)。根据ATFL分束数目,将其定义为Ⅰ型(单束)、Ⅱ型(双束)和Ⅲ型(三束),各占27.9%、65.1%和7%。根据ATFL和CFL纤维在腓骨止点部位的浅-深层关系,分为浅表型(8例,18.6%)、平行型(19例,44.2%)、深层型(9例,20.9%)和混合型(7例,16.3%);根据其上-下关系,分为完全型(5例,9.3%)、上部型(15例,34.9%)和下部型(24例,55.8%)。同时,在7例标本中发现了复合体结构,占总数的16.3%。 外侧距跟韧带存在于46.5%的标本中:A型(25.6%);B型(20.9%);余下23例(53.5%)为C型。   结论 踝关节外侧韧带在形态上存在一定变异性。形态学研究可能有助于指导临床诊断和治疗,同时可为更深入地探讨各韧带的功能提供解剖学依据。

关键词:  , 踝关节; 外踝韧带; 解剖学分型

Abstract: Objective To study the morphological characteristics of lateral ankle ligaments and to explore their clinical significance. Methods Dissection was performed on 43 ankle specimens. Bundle number, route, origin and insertion for each lateral ankle ligament, and fibrous relationship near their attachments were observed and recorded. Results Anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) were dissected in all specimens. According to the number of ATFL bundles, the single bundle, double bundles and three bundles were defined as typeⅠ, typeⅡ and typeⅢ, accounting for 27.9%, 65.1 % and 7%, respectively. Based on the surface-deep position of the insertions of ATFL and CFL fibers at the fibula, they were divided into the following type: superficial type (8 cases, accounting for 18.6%), parallel type (19 cases, accounting for 44.2%), deep type (9 cases, accounting for 20.9%) and mixed type (7 cases, accounting for 16.3%). According to the superior-inferior attachment of ATFL-CFL, the insertion was divided into the following type: total type (5 cases, accounting for 9.3%), superior type (15 cases, accounting for 34.9%) and inferior type (24 cases, accounting for 55.8%). In 7 specimens, ATFL and CFL inserted on fibula with a complex structure, accounting for 16.3% of the total sample size. Lateral talocalcaneal ligament (LTCL) was present in 46.5% (20/43) specimens: type A 25.6%, type B 20.9%. LTCL was absent in the remaining 23 cases (53.5%). Conclusions The lateral ankle ligaments in Chinese specimens has some morphological variability. Morphological study would be helpful for clinical diagnosis and treatment, and it might provide anatomical basis for further exploration of the function of these ligaments.

Key words: Ankle,  Lateral ankle ligament,  Anatomic classification

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