Zwipp H
Unfallchirurg. 1989 Mar;92(3):98-102.
According to Fick, the tree-dimensional patterns of foot motion are best characterized as jawlike movement. Anatomically and biomechanically, this process represents conjoined, synchronous motion within the three mobile segments of the hindfoot: the ankle joint, the posterior subtalar joint, and the anterior subtalar joint. Foot kinematics can be described more completely if the anterior subtalar joint is defined not only as the talocalcaneal navicular joint, but as including the calcaneocuboid joint, thus representing the transverse joint of the tarsus, i.e., the Chopart joint. The axes of these three joints can be defined precisely. In some parts they represent a screwlike motion, clockwise or counter-clockwise, around the central ligamentous structures (fibulotibial ligament, talocalcaneal interosseous ligament, bifurcate ligament). The individual anatomy and structure of these ligaments provide variations in the degree and direction of foot motion. A precise knowledge of foot kinematics is important in surgical ligament and joint reconstruction and in selective foot arthrodeses.
根据菲克的理论,足部运动的三维模式最典型的特征是类似颌部的运动。从解剖学和生物力学角度来看,这个过程表现为后足三个可动节段内的联合、同步运动:踝关节、距下后关节和距下前关节。如果将距下前关节不仅定义为距跟舟关节,还包括跟骰关节,从而代表跗骨的横关节,即Chopart关节,那么足部运动学就能得到更完整的描述。这三个关节的轴可以精确界定。在某些部位,它们围绕中央韧带结构(腓胫韧带、距骨间韧带、分歧韧带)做顺时针或逆时针的螺旋状运动。这些韧带的个体解剖结构和形态使得足部运动在程度和方向上存在差异。精确了解足部运动学对于韧带和关节的手术重建以及选择性足部关节融合术至关重要。