论文部分内容阅读
目的带血供第2楔骨-跗跖背侧韧带-跖骨瓣重建距腓前韧带提供解剖学基础。方法在6例经防腐固定的成人下肢标本及6例新鲜标本上观测距腓前韧带起止点及行径,第2跗跖背侧韧带的解剖形态与起止点,在新鲜标本上模拟重建手术。结果第2跗跖背侧韧带位置恒定,解剖层次表浅,切取方便,第2楔骨-跗跖背侧韧带-跖骨瓣的背侧韧带长度(4.1±0.4)cm,距腓韧带长度(2.4±0.5)cm。(1)第2楔骨-跗跖背侧韧带-跖骨瓣的背侧韧带具有足够的长度,可形成移植供体;(2)带血供第2楔骨-跗跖背侧韧带-跖骨瓣复合体两端分别与骨创面固定,容易成活和恢复功能;(3)临床应用12例,全部病人随访4月~2年,重建后距腓前韧带可纠正踝内翻畸形,骨瓣愈合时间为2~3个月,踝关节功能满意,无再断裂并发症。结论骨瓣修整后的背侧韧带重建距腓前韧带有术式简单,重建韧带结构接近正常,受区损伤小等优点;采用带血供第2楔骨-跗跖背侧韧带-跖骨瓣重建距腓前韧带具有可行性。
Objective To provide anatomical basis for the reconstruction of the anterior fibular ligament using the second wedge-tarsal plantar dorsal ligament-metatarsal flap. Methods The anatomical structures and starting and ending points of the second tarsus plantar dorsal ligaments were observed in 6 cases of preserved lower extremity specimens and 6 fresh specimens. The reconstructive surgery was performed on fresh specimens. Results The dorsal ligaments of the second plantar tarsometa were located at a constant level with superficial dissection and easy dissection. The dorsal ligament length (4.1 ± 0.4) cm of the second wedge - plantar tarsal ligament - metatarsal flap was ± 0.5) cm. (1) The second wedge - tarsometatarsal dorsal - the dorsal ligaments of the metatarsal flap have sufficient length to form a transplanted donor; (2) blood for the second wedge - the tarsometatarsal dorsal ligament - the metatarsal flap (3) Clinical application of 12 cases, all patients were followed up for 4 months to 2 years, after reconstruction from the anterior fibular ligament can correct ankle varus deformity, bone flap healing time For 2 to 3 months, ankle function satisfactory, no further rupture complications. Conclusion Reconstruction of the dorsal bone flap with anterior talofibular ligament has the advantages of simple operation, reconstructed ligament structure close to normal and less damage to the area. The blood supply for reconstruction of the second wedge-tarsal plantar dorsal ligaments-metatarsal flap Feet from the peroneal ligament is feasible.