Ray Ronald G
Foot and Ankle Clinic of Montana, Affiliate, Great Falls Clinic, 1301 11th Avenue South, Suite 6, Great Falls, MT 59405, USA.
Clin Podiatr Med Surg. 2016 Oct;33(4):467-80. doi: 10.1016/j.cpm.2016.06.001. Epub 2016 Aug 9.
There are a number of variations in the intra-articular anatomy of the ankle which should not be considered pathological under all circumstances. The anteromedial corner of the tibial plafond (between the anterior edge of the tibial plafond and the medial malleolus) can have a notch, void of cartilage and bone. This area can appear degenerative arthroscopically; it is actually a normal variant of the articular surface. The anterior inferior tibiofibular ligament (AITF) can possess a lower, accessory band which can impinge on the anterolateral edge of the talar dome. In some cases it can cause irritation along this area of the talus laterally. If it is creating local irritation it can be removed since it does not provide any additional stabilization to the syndesmosis. There is a beveled region at the anterior leading edge of the lateral and dorsal surfaces of the talus laterally. This triangular region is void of cartilage and subchondral bone. The lack of talar structure in this region allows the lower portion of the AITF ligament to move over the talus during end range dorsiflexion of the ankle, preventing impingement. The variation in talar anatomy for this area should not be considered pathological.
踝关节的关节内解剖结构存在多种变异情况，在所有情况下都不应被视为病理性的。胫骨平台的前内侧角（在胫骨平台前缘与内踝之间）可能有一个无软骨和骨质的切迹。该区域在关节镜下可能呈现退变表现；实际上它是关节面的一种正常变异。胫腓前下韧带（AITF）可能有一条较低的副束带，可压迫距骨穹窿的前外侧边缘。在某些情况下，它可导致距骨外侧该区域出现刺激症状。如果它引起局部刺激，可将其切除，因为它对下胫腓联合并无额外的稳定作用。在距骨外侧的外侧和背侧表面的前缘有一个斜面区域。这个三角形区域无软骨和软骨下骨。该区域缺乏距骨结构，使得在踝关节终末背屈时，AITF韧带的下部能够在距骨上移动，从而防止撞击。该区域距骨解剖结构的变异不应被视为病理性的。
