距腓前韧带与踝间后韧带的解剖学研究及其临床意义
Anterior talofibular and the posterior intermalleolar ligaments: anatomy and clinical significance
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。
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.
Ankle joint / Anterior talofibular ligament / Posterior intermalleolar ligament / Applied  / anatomy
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吉林省科技厅青年科研基金(201101078)
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