踝关节距腓前韧带和跟腓韧带的解剖学测量及变异分析
Anatomic Measurement and Variability Analysis of the Anterior Talofibular Ligament and Calcaneofibular Ligament of the Ankle.
作者信息
Yang Han, Su Minghao, Chen Zhimin, Qu Rongmei, Yuan Zhirong, Yuan Jiajie, He Shanli, Li Zeyu, Liu Chang, Xiao Zhaoming, Liang Haibin, Ouyang Jun, Dai Jingxing
机构信息
The First Clinical Medicine College, Southern Medical University, Guangzhou, China.
Guangdong Provincial Key Laboratory of Medical Biomechanics, Department of Anatomy, School of Basic Medical Science, Southern Medical University, Guangzhou, China.
出版信息
Orthop J Sports Med. 2021 Nov 19;9(11):23259671211047269. doi: 10.1177/23259671211047269. eCollection 2021 Nov.
BACKGROUND
The anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) contribute greatly to the overall stability of the ankle joint; however, ATFL and combined ATFL-CFL sprains are common. Anatomic reconstruction of the lateral collateral ligament with grafts has been proposed for patients with poor tissue quality or inadequate local tissue. Anatomic reconstruction of the lateral ankle ligaments requires a good understanding of their anatomic location.
PURPOSE
To describe the anatomy of the ATFL and CFL ligaments quantitatively and qualitatively and explore the relationship of some morphological parameters.
STUDY DESIGN
Descriptive laboratory study.
METHODS
A total of 66 adult ankle specimens were analyzed for ATFL band type, origin, length, width, thickness, and angle between the ATFL and CFL, and 73 adult ankle specimens were used for measuring the origin of the CFL. The coefficient of variation was used to describe and compare the respective variability of angle, length, width, and thickness. The origin of the ATFL was labeled as point , and the leading edge of the CFL intersection with the articular surface of the calcaneus was considered point .
RESULTS
The ATFL had a variable number of bands. A high degree of variability (coefficient of variation >0.2) was seen for most morphological measurements of the ATFL. In addition, the length of distance also varied. The CFL originated at the tip of the fibula in only 9% of specimens. It was found more commonly at the anterior border of the lateral malleolus (4.94 ± 1.70 mm from the tip). The angle between the ATFL and CFL was consistent at 100° to 105º.
CONCLUSION
A fair amount of variability of ATFL length, width, and thickness were found in our study, with less variability in the ATFL-CFL angle. Most CFLs attached anterior to the tip of the fibula.
CLINICAL RELEVANCE
Providing relevant anatomic data of ATFL and CFL is important in ensuring proper surgical treatment of ankle joint injuries.
背景
距腓前韧带（ATFL）和跟腓韧带（CFL）对踝关节的整体稳定性起着重要作用；然而，ATFL损伤以及ATFL合并CFL损伤很常见。对于组织质量差或局部组织不足的患者，有人提出用移植物对外侧副韧带进行解剖重建。踝关节外侧韧带的解剖重建需要对其解剖位置有很好的了解。
目的
定量和定性描述ATFL和CFL韧带的解剖结构，并探讨一些形态学参数之间的关系。
研究设计
描述性实验室研究。
方法
对66个成人踝关节标本分析ATFL的束带类型、起点、长度、宽度、厚度以及ATFL与CFL之间的夹角，73个成人踝关节标本用于测量CFL的起点。变异系数用于描述和比较角度、长度、宽度和厚度各自的变异性。将ATFL的起点标记为点 ，CFL与跟骨关节面交点的前缘视为点 。
结果
ATFL的束带数量不一。ATFL的大多数形态学测量结果显示出高度变异性（变异系数>0.2）。此外，距离 的长度也有所不同。仅9%的标本中CFL起于腓骨尖。更常见的是起于外踝前缘（距尖4.94±1.70mm）。ATFL与CFL之间的夹角在100°至105°之间较为一致。
结论
本研究发现ATFL的长度、宽度和厚度存在相当大的变异性，而ATFL与CFL之间的夹角变异性较小。大多数CFL附着于腓骨尖前方。
临床意义
提供ATFL和CFL的相关解剖数据对于确保踝关节损伤的正确手术治疗很重要。
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