Berberian W S, Hecht P J, Wapner K L, DiVerniero R
New Jersey Medical School, Newark 07103-2714, USA.
Foot Ankle Int. 2001 Apr;22(4):313-7. doi: 10.1177/107110070102200407.
The purpose of this study was to document radiographic trends in the size and location of osteophytes occurring in patients who have undergone surgical treatment of bony anterior ankle impingement. All patients over a period of 31 months who had undergone surgical excision of anterior ankle osteophytes were identified. 9 patients (10 ankles) in whom preoperative CT scans were available were selected as the study group. This group was retrospectively reviewed in terms of basic preoperative characteristics (age, sex, symptomatology, sports history, systemic disease, passive dorsiflexion). Osteophyte size was measured on plain lateral radiographs, and axial CT images were used to determine both tibial and talar osteophyte location by referencing them to the midline of the talar dome. 95% confidence intervals demonstrated that the talar spur peak lies medial to the midline, the tibial spur peak lies lateral to the midline, and the spurs typically do not overlap each other. Further, the tibial spur is wider than the talar spur, and the talar spur usually protrudes medially off the medial edge of the talar neck. Thus, there is evidence that anterior tibiotalar osteophytes may have a relatively consistent pattern of formation, with the talar spur occurring on the medial aspect of the talar neck, and the tibial spur peaking lateral to the midline.This information, if substantiated with additional patients, may provide insight into the pathophysiology of anterior ankle impingement, as well as facilitate the open and arthroscopic approaches toward resection of these lesions.
本研究的目的是记录接受骨性前踝撞击症手术治疗患者骨赘大小和位置的影像学变化趋势。确定了在31个月期间所有接受前踝骨赘手术切除的患者。选择9例（10个踝关节）有术前CT扫描资料的患者作为研究组。对该组患者的术前基本特征（年龄、性别、症状、运动史、全身疾病、被动背屈）进行回顾性分析。在普通侧位X线片上测量骨赘大小，并通过将轴向CT图像与距骨穹顶中线进行对照来确定胫骨和距骨骨赘的位置。95%置信区间表明，距骨骨刺峰值位于中线内侧，胫骨骨刺峰值位于中线外侧，且骨刺通常不相互重叠。此外，胫骨骨刺比距骨骨刺宽，距骨骨刺通常从距骨颈内侧边缘向内侧突出。因此，有证据表明胫距前骨赘可能具有相对一致的形成模式，距骨骨刺出现在距骨颈内侧，胫骨骨刺峰值位于中线外侧。如果更多患者能证实这一信息，可能有助于深入了解前踝撞击症的病理生理学，并有助于采用开放手术和关节镜手术切除这些病变。
