距腓前韧带与踝间后韧带的解剖学研究及其临床意义

中国临床解剖学杂志 ›› 2012, Vol. 30 ›› Issue (4): 379-381.

距腓前韧带与踝间后韧带的解剖学研究及其临床意义

许涛¹，　刘志刚²，　宋良松²，　陈雷²

1.江苏省苏北人民医院骨科，扬州 225000; 2.吉林大学白求恩第一医院手足外科，长春 130031

收稿日期:2012-03-07 出版日期:2012-07-25 发布日期:2012-07-27
通讯作者: 刘志刚，主任医师，教授，硕士生导师，Tel:(0431)84808252 E-mail:xuchangwen22317@163.com
作者简介:许涛（1983-）男，山东青岛人，在读硕士，医师，主要研究方向为周围神经损伤与骨关节，Tel:（0431）84808259,15143169968
基金资助:
吉林省科技厅青年科研基金（201101078）

Anterior talofibular and the posterior intermalleolar ligaments: anatomy and clinical significance

XU Tao1, LIU Zhi-gang2, SONG Liang-song2, CHEN Lei2

1.Department of Orthopedics, Subei People's Hospital of Jiangsu Province, Yangzhou 225001 China; 2. Department of Hand and Foot Surgery, The first Bethune Hospital of Jilin University, Changchun, 130031 China

Received:2012-03-07 Online:2012-07-25 Published:2012-07-27

摘要/Abstract

摘要：

目的　研究距腓前韧带和踝间后韧带的解剖学特点，探讨其功能与临床意义。方法　10侧成人踝关节标本解剖观测距腓前韧带和踝间后韧带起止、走行和比邻，并分析其作用。结果　10侧标本中，有7侧的距腓前韧带呈双束结构，占70%，在此结构中，两束宽度之和大于单束结构的韧带的宽度。双束呈类“人”字形走行，两个束支在足处于不同的位置时呈不同的状态，当足跖屈时，下束松弛，上束绷紧；背屈位时则反之。踝间后韧带起自外踝腓骨尖后下缘向内侧走行，大体分为3束，分别止于胫骨后下缘、胫后肌腱腱鞘、距骨后结节及其内侧，此韧带对维持踝关节稳定，防止距骨后脱位有重要的作用。结论　距腓前韧带的双束结构能加强其强度，踝间后韧带的生物力学及其参与踝后软组织撞击综合征的机理值得进一步探讨。

关键词: 踝关节, 距腓前韧带, 踝间后韧带, 应用解剖

Abstract:

Objective　To study anatomic characteristics of the anterior talofibular and the posterior intermalleolar ligaments, and explore their functions and clinic significance. Methods　10 ankle joint specimens from adult fresh cadavers were used. The anterior talofibular and the posterior intermalleolar ligaments were carefully dissected. The origin, insertion points, coruse and the adjacent structures were observed. the functions of those ligaments were analyzed. Results　The anterior talofibular ligaments of 7 cases （70%）presented the double-banded shape, with the increased width of two bands compared to that of one-banded ligaments. the course of two bands formed the shape of "人". In plantar flexion, the inferior band of the ligament remains relaxed while the upper band became taut. In dorsiflexion, the upper band remains relaxed, and the inferior band became tight. The posterior intermalleolar ligament ran obliquely from lateral to medial. The medial arising sites of the ligament included the lateral border of the medial malleolar sulcus, the medial border of the medial malleolar sulcus through the septum between the flexor digitorum longus and posterior tibial tendons, the posterior distal margin of the tibia, and the posterior process of the talus through the joint capsule. This ligament was important to sustain the stabilization of the malleolar joint and to prevent the astragalar dislocation. Conclusions　The double-banded structure of anterior talofibular ligament can strengthen the intensity. It is worthy to do a further study about the mechanism that the posterior intermalleolar ligament involvement in the posterior soft tissue impingement syndrome of the ankle.

Key words: Ankle joint, Anterior talofibular ligament, Posterior intermalleolar ligament, Applied , anatomy

中图分类号:

许涛, 刘志刚, 宋良松, 陈雷. 距腓前韧带与踝间后韧带的解剖学研究及其临床意义[J]. 中国临床解剖学杂志, 2012, 30(4): 379-381.

HU Chao, LIU Zhi-Gang, SONG Liang-Song, CHEN Lei. Anterior talofibular and the posterior intermalleolar ligaments: anatomy and clinical significance[J]. Chinese Journal Of Clinical Anatomy, 2012, 30(4): 379-381.

参考文献

[1] 毛宾尧.踝关节不稳
[J].中华关节外科杂志（电子版）,2009, 3(1):82-85.

[2] Brostrom L. Sprained ankles V. Treatment and prognosis in recent ligament ruptures
[J]. Acta Chir Scand，1966,132(5):537-550.

[3] Burks RT, Morgan J. Anatomy of the lateral ankle ligaments
[J]. Am J Sport Med, 1994, 22(1):72-77.

[4] Delfaut EM, Demondion X, Boutry N, et al. Multi-fasciculated anterior talofibular ligament: reassessment of normal findings
[J]. Eur Radiol, 2003,13(8):1836-1842.

[5] Milner CE, Soames RW. Anatomical variations of the anterior talofibular ligament of the human ankle joint
[J]. J Anat, 1997,191(Pt 3):457-458.

[6] Milner CE, Soames RW. Anatomy of the collateral ligaments of the human ankle joint
[J]. Foot Ankle Int ,1998,19(11):757-760.

[7] 高士濂. 实用解剖学图谱下肢分册
[M]. 第2版. 上海：上海科技出版社，2004：270-280.

[8] Paturet G. Traite' d’anatomie humaine (A treatise on human anatomy)
[J]. Par's Masson, 1951:704-711.

[9] Sarrafian SK. Anatomy of the foot and ankle
[M]. Descriptive,topographic, functional, 2nd ed. Lippincott, Philadelphia,pp,1993:159-217.

[10] 王玉玺，阳红林，岳学强, 等. 踝关节距腓前韧带呈双条状排列的报导
[J].解剖科学进展, 2009,15(1):125-126.

[11] Van den Bekerom MPJ, Oostra RJ, Golano? P, et al. The anatomy in relation to injury of the lateral collateral ligaments of the ankle: a current concepts review
[J]. Clin Anat, 2008, 21(7):619-626.

[12] Boruta PM, Bishop JO, Braly WG, et al. Acute ankle ligament injuries: a literature review
[J]. Foot Ankle , 1990, 11(2):107-113.

[13] Colville MR. Reconstruction of the lateral ankle ligaments
[J]. J Bone Joint Surg Am, 1994, 76:1092-1102.

[14] Rosenberg ZS, Cheung YY, Beltran J, et al. Posterior intermalleolar ligament of the ankle: normal anatomy and MR imaging features
[J]. AJR, 1995,165(2):387-390.

[15] Peace KAL, Hillier JC, Hulme A, et al. MRI features of posterior ankle impingement syndrome in ballet dances: a review of 25 cases
[J]. Clin Radiol, 2004, 59(11):1025-1033.