关键词: 第2楔骨-跗跖背侧韧带-跖骨瓣, 距腓前韧带, 重建, 应用解剖

Abstract:

Objective　To provide anatomical basis for blood supply of second cuneiform bone - dorsal tarsometatarsal ligaments - metatarsal flap to reconstruction talofibular ligament.　Methods　In 6 embalmed adult cadavers and 6 fresh specimens the origin, insertion and course of the talofibular ligament, the origin, insertion and course of the 2nd dorsal tarsometatarsal ligament were observed. simulated reconstruction surgery were conducted on fresh specimens.　Result  The tarsometatarsal ligaments was consistent and superficially located and easy to harvest, the second cuneiform bone- dorsal tarsometatarsal ligaments-dorsal metatarsal ligament flap was (4.1±0.4) cm in length, while the talofibular ligament length was (2.4±0.5) cm in length.（1）The dorsal ligaments from second cuneiform bone - dorsal tarsometatarsal ligaments - metatarsal flap had sufficient length to serve as a transplant donor site. (2) Second cuneiform bone - dorsal tarsometatarsal ligaments - metatarsal flap were fixed at both ends to the bone wounds, making it easy to survive and restore functions. (3) the flap was clinically applied in 12 cases. All patients were followed up for 4 months to 2 years ,and it was found that the reconstituted talofibular ligament can correct varus deformity of the ankle; the average bone healing time was 2 to 3 months; all patients were satisfied with the ankle function and no further fracture complications were encountered.　Conclusion　The second cuneiform bone - dorsal tarsometatarsal ligaments - metatarsal flap is similar in anatomical structure to talofibular ligamet. The reconstruction surgery is simple in procedure and minimal in donor site trauma. Using second cuneiform bone - dorsal tarsometatarsal ligaments -metatarsal flap for reconstruction of the talofibular ligament is feasible anatomically and clinically.

Key words: Second cuneiform bone - dorsal tarsometatarsal ligaments - metatarsal flap, Anterior talofibular ligament, Reconstruction, Applied anatomy