论文部分内容阅读
目的研究跟骰关节面的形态特征,为跟骨前部内固定置钉提供解剖学依据。方法笔者自2013-01—2015-06解剖40只成年人足踝部标本,分为男、女2组(男22只,女18只)。每只标本来源于不同个体,不分左右侧别。以跟骨长轴作为解剖测量基线,解剖观察跟骰关节面形状,测量跟骰关节面水平横径和最大横径,测量并计算后斜角。分析测量指标与跟骨骨折内固定置钉之间关系。结果测量结果显示,男性组跟骰关节面的水平横径为(25.03±1.37)mm,最大横径为(31.24±2.13)mm,女性组水平横径为(23.51±2.11)mm,最大横径为(27.39±1.87)mm。2项指标组间比较,差异均有统计学意义(t=2.478,P=0.009;t=6.003,P<0.001)。男性组和女性组的后斜角分别为(23.03±1.71)°和(20.69±2.30)°,差异有统计学意义(t=3.689,P=0.001)。结论跟骰关节面是一个不规则的倾斜关节面。自跟骨前部外侧向内侧置钉,关节面的后斜角决定进钉方向,水平横径和最大横径决定进钉长度。按照研究结论和方法置入合适长度螺钉,能避免螺钉误置入跟骰关节,也可以避免由于螺钉过长而损伤跟骨内侧的肌腱、血管和神经。
Objective To study the morphological features of the calcaneal surface and provide anatomic evidence for the internal fixation of the calcaneus. Methods The author dissected 40 adult ankle samples from 2013-01-2015-06, divided into male and female 2 groups (22 males and 18 females). Each specimen from different individuals, regardless of left and right side do not. With the long axis of the calcaneus as the baseline for anatomical measurement, the shape of the heel surface was dissected and the horizontal and maximum diameters of the articular surface of the heel were measured. The bevel angle was measured and calculated. Analysis of measurement and calcaneal fracture fixation with the relationship between the internal fixation. Results The measurement results showed that the horizontal diameter of the male and the dorsal articular surface was (25.03 ± 1.37) mm and the maximum diameter was (31.24 ± 2.13) mm, while the horizontal diameter of the female was (23.51 ± 2.11) mm and the maximum diameter (27.39 ± 1.87) mm. There were significant differences between the two groups (t = 2.478, P = 0.009; t = 6.003, P <0.001). The posterior bevels of the male and female groups were (23.03 ± 1.71) ° and (20.69 ± 2.30) °, respectively, and the difference was statistically significant (t = 3.689, P = 0.001). Conclusion The heel articular surface is an irregular oblique articular surface. From the anterior lateral calcaneus to the inside of the nail, the posterior oblique angle of the articular surface determines the direction of the nail, the horizontal diameter and the maximum diameter determine the length of the nail. In accordance with the conclusions and methods of research into the appropriate length of the screw, the screw can be avoided inadvertently inserted into the heel joint, but also to avoid damage to the medial calcaneus tendons, blood vessels and nerves due to the screw is too long.