踝关节外侧韧带的形态学分型及临床意义

doi:10.13418/j.issn.1001-165x.2021.02.001

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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

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

作者信息 +

Morphological classification of the lateral ankle ligaments and clinical significance

Zhou Yunfeng¹, Xu Dazheng², Chen Zhong¹, Yao Huosheng², Zhang Congda¹, Li Weiping¹, Shen Huiyong^1,3, Song Bin¹

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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。

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.

导出引用

周云烽, 徐达政, 陈仲, 姚伙生, 张琮达, 李卫平, 沈慧勇, 宋斌. 踝关节外侧韧带的形态学分型及临床意义[J]. 中国临床解剖学杂志. 2021, 39(2): 121-125 https://doi.org/10.13418/j.issn.1001-165x.2021.02.001

Zhou Yunfeng, Xu Dazheng, Chen Zhong, Yao Huosheng, Zhang Congda, Li Weiping, Shen Huiyong, Song Bin. Morphological classification of the lateral ankle ligaments and clinical significance[J]. Chinese Journal of Clinical Anatomy. 2021, 39(2): 121-125 https://doi.org/10.13418/j.issn.1001-165x.2021.02.001

中图分类号： R322.73 R323.72　

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