Szaro Paweł, Ghali Gataa Khaldun, Polaczek Mateusz
Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland.
Surg Radiol Anat. 2021 Jul;43(7):1083-1090. doi: 10.1007/s00276-021-02694-w. Epub 2021 Feb 7.
The aim of the study was to examine the ligaments of the os trigonum.
The ankle joint magnetic resonance imaging (MRI) of 104 patients with the os trigonum (experimental group) and 104 patients without the os trigonum (control group) were re-reviewed. The connections of the os trigonum and posterior talofibular ligament (PTFL), the fibulotalocalcaneal ligament (FTCL), the paratenon of the Achilles tendon, the posterior talocalcaneal ligament (PTCL), the osteofibrous tunnel of the flexor hallucis longus (OF-FHL) and the flexor retinaculum (FR) were studied.
The os trigonum is connected to structures. The posterior part of the PTFL inserted on the os trigonum in 85.6% of patients, whereas in all patients in the control group, the posterior part of the PTFL inserted on the posterior talar process (p < 0.05). The connection of the PTCL was seen in 94.2% of patients in the experimental group, while it was seen in 90.4% of patients in the control group (p > 0.05). The connection to the FTCL in the experimental group was 89.4%, while in the control group, it was 91.3% (p > 0.05). The communication with the paratenon was seen more often in the control group compared to that in the experimental group (31.7% vs. 63.8%, p < 0.001). The FTCL was prolonged medially into the FR in 85.6% of patients in the experimental group and in 87.5% of patients in the control group (p > 0.05). The flexor hallucis longus (FHL) run at the level of articulation between the os trigonum 63.5% and the posterior process of the talus 25% and less often on the os trigonum 11.5%.
The os trigonum is connected with all posterior ankle structures and more connections than previously reported.
本研究旨在检查三角骨的韧带。
对104例有三角骨的患者（实验组）和104例无三角骨的患者（对照组）的踝关节磁共振成像（MRI）进行重新评估。研究了三角骨与距腓后韧带（PTFL）、腓骨距跟韧带（FTCL）、跟腱腱旁组织、距跟后韧带（PTCL）、拇长屈肌骨纤维隧道（OF-FHL）和屈肌支持带（FR）的连接情况。
三角骨与一些结构相连。85.6%的患者中，PTFL的后部附着于三角骨，而对照组所有患者中，PTFL的后部附着于距骨后突（p<0.05）。实验组94.2%的患者可见PTCL的连接，而对照组为90.4%的患者（p>0.05）。实验组与FTCL的连接率为89.4%，而对照组为91.3%（p>0.05）。与腱旁组织的连通在对照组中比实验组中更常见（31.7%对63.8%，p<0.001）。实验组85.6%的患者和对照组87.5%的患者中，FTCL向内侧延伸至FR（p>0.05）。拇长屈肌（FHL）走行于三角骨与距骨后突之间关节水平的占63.5%，走行于距骨后突的占25%，走行于三角骨的较少，占11.5%。
三角骨与踝关节后部所有结构相连，且连接比之前报道的更多。
