Jorge João Torrinha, Gomes Tiago Mota, Oliva Xavier Martin
Department of Orthopedic Surgery, Hospital Curry Cabral - CHLC, Rua da Beneficência no. 8, 1069-166 Lisboa, Portugal.
University of Barcelona, Calle Casanova, 143, 08038 Barcelona, Spain.
Foot Ankle Surg. 2018 Apr;24(2):143-148. doi: 10.1016/j.fas.2017.01.005. Epub 2017 Jan 20.
The purpose of this anatomical study to was to determine the relationship of the structures involved in the arthroscopic repair of the anterior talofibular ligament.
Dissection of fifteen lower leg cadaveric specimens was made and distances in the anterior direction from the reference-point at the lateral malleolus origin of the anterior talofibular ligament were measured, to the talar insertion of the ligament, to the superficial peroneal nerve at 60° and 90° in relation to the lateral malleolus axis in the sagittal plane, and to the inferior extensor retinaculum.
The mean±SD distance to superficial peroneal nerve from the reference-point was 25±6 (range 17-35) mm at 60°, and 32±9 (range 24-48) mm at 90° in relation to the lateral malleolus axis. The mean±SD distance to the inferior extensor retinaculum was 20±5 (range 14-29) mm. The mean±SD length of the anterior talofibular ligament was 21±4 (range 13-29) mm.
The superficial peroneal nerve demonstrated the greatest variance in its anatomy. An accessory incision to include the inferior extensor retinaculum in the repair should not surpass the 22mm distance from the lateral malleolus in the anterior direction, due to the risk of damaging the nerve.
本解剖学研究的目的是确定参与距腓前韧带关节镜修复的结构之间的关系。
对15个小腿尸体标本进行解剖，测量从距腓前韧带在外踝起点的参考点向前至韧带在距骨的止点、在矢状面相对于外踝轴60°和90°处至腓浅神经以及至下伸肌支持带的距离。
相对于外踝轴，在60°时从参考点至腓浅神经的平均±标准差距离为25±6（范围17 - 35）mm，在90°时为32±9（范围24 - 48）mm。至下伸肌支持带的平均±标准差距离为20±5（范围14 - 29）mm。距腓前韧带的平均±标准差长度为21±4（范围13 - 29）mm。
腓浅神经在解剖结构上变异最大。由于存在损伤神经的风险，在修复中包括下伸肌支持带的辅助切口在向前方向上距外踝的距离不应超过22mm。
