Higashiyama Reiji, Sekiguchi Hiroyuki, Takata Ken, Endo Tachio, Takaso Masashi
Department of Orthopaedic Surgery, Shonantobu General Hospital, Kanagawa, Japan.
Department of Orthopaedic Surgery, Kitasato University School of Medicine, Kanagawa, Japan.
Arthrosc Tech. 2020 Jan 21;9(2):e217-e223. doi: 10.1016/j.eats.2019.09.020. eCollection 2020 Feb.
The lateral talocalcaneal ligament (LTCL) connects the talus and calcaneus on the lateral side of the hindfoot. Although its function remains has not yet been clearly elucidated, the LTCL is thought to be important for the stabilization of the subtalar joint. Ankle sprains often include not only the talocrural joint but also the subtalar joint; therefore, LTCL injuries occur at a certain rate. Moreover, surgeons often encounter and reluctantly dissect the LTCL during arthroscopic anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) reconstruction because the LTCL connects to the ATFL at the talus in 42% of people and connects to the CFL at the calcaneus in 18% of people. As a result, LTCL reconstruction might be necessary for those patients. We describe the arthroscopic reconstruction technique of the ATFL, LTCL, and CFL using a triangle-shaped tendon graft (ALC-triangle). This technique provides a possible advantage of an anatomical and stable talocrural joint and subtalar joint.
距下外侧韧带（LTCL）在后足外侧连接距骨和跟骨。尽管其功能尚未完全阐明，但LTCL被认为对距下关节的稳定很重要。踝关节扭伤通常不仅累及胫距关节，还累及距下关节；因此，LTCL损伤有一定的发生率。此外，在关节镜下进行距腓前韧带（ATFL）和跟腓韧带（CFL）重建时，外科医生经常会遇到并不得不分离LTCL，因为在42%的人当中，LTCL在距骨处与ATFL相连，在18%的人当中，LTCL在跟骨处与CFL相连。因此，对于这些患者可能需要进行LTCL重建。我们描述了使用三角形肌腱移植物（ALC-三角形）进行ATFL、LTCL和CFL关节镜重建的技术。该技术可能为获得解剖学上稳定的胫距关节和距下关节提供优势。
