Orthopaedic Department, University Hospital Basel, Basel, Switzerland.
Clin Anat. 2012 Sep;25(6):773-80. doi: 10.1002/ca.22042. Epub 2012 Feb 3.
To successfully surgically reconstruct osteochondral lesions of the talus, the exact three-dimensional (3D) configuration of the upper articular surface of the talus has to be respected. We assessed the talar geometry by measuring the coronal and sagittal talar edge radius and the frontal talar profile in multiplanar reconstructions of computer tomographic (CT) studies of 79 patients (83 feet) with a healthy ankle joint. An image visualization software designated for coordinate measurement was used to perform the measurement. In the coronal plane, the mean lateral talar edge radius was 4.0 mm and the medial 4.5 mm. In the sagittal planes the mean lateral talar edge radius was 20.3 mm, the radius of the sulcus 20.7 mm and the medial talar edge radius 20.4 mm. The talus showed a concave shape in coronal cuts. These results show a significant difference between medial and lateral talar edge configuration in coronal planes. The measurements of the lateral and medial sagittal radius and the mid-sagittal radius in the sulcus tali show no statistically significant difference. The depth of the talar sulcus shows no correlation to age or sex. Different sizes of custom-made tissue-engineered grafts according to the location of the osteochondral lesion at the talus are needed for exact surgical reconstruction of the anatomy. Osteochondral lesions are three dimensional; therefore, a 3D preoperative planning tool by CT scan or MRI is mandatory.
为了成功地对距骨骨软骨病变进行手术重建，必须尊重距骨上关节面的精确三维（3D）形态。我们通过测量冠状和矢状距骨边缘半径以及额状距骨轮廓，评估了 79 例（83 足）健康踝关节患者的计算机断层扫描（CT）研究的多平面重建中的距骨几何形状。使用用于坐标测量的图像可视化软件进行测量。在冠状面，外侧距骨边缘半径的平均值为 4.0 毫米，内侧为 4.5 毫米。在矢状面，外侧距骨边缘半径的平均值为 20.3 毫米，沟的半径为 20.7 毫米，内侧距骨边缘半径为 20.4 毫米。距骨在冠状切面上呈凹形。这些结果表明，冠状面中距骨内外侧边缘形态存在显著差异。外侧和内侧矢状半径以及距骨沟中部矢状半径的测量值在统计学上没有显著差异。距骨沟的深度与年龄或性别无关。根据距骨骨软骨病变的位置，需要根据病变位置定制不同大小的组织工程移植物，以进行精确的手术重建。骨软骨病变是三维的；因此，CT 扫描或 MRI 的 3D 术前规划工具是强制性的。
