Mabit C, Boncoeur-Martel M P, Chaudruc J M, Valleix D, Descottes B, Caix M
Laboratoire d'Anatomie, Faculté de Médecine, Limoges, France.
Surg Radiol Anat. 1997;19(2):111-7. doi: 10.1007/BF01628135.
The diagnosis of subtalar instability remains difficult both clinically and radiographically. The authors present an anatomic and MRI study of the subtalar ligamentous support. The anatomic study has consisted in dissections and sections of cryoconserved hindfeet (15 cases) which precises the organisation of ligamentous bundles in the lateral (sinus tarsi) and central (canalis tarsi) subtalar compartments, mainly represented by the trilayered inferior extensor retinaculum, the cervical talo-calcaneal ligament and the interosseous talo-calcaneal ligament. MRI study (1.5 tesla) of anatomic specimens was performed according to defined types of sections: sagittal, coronal, coronal oblique, axial transverse. The correlations of anatomic and MRI sections allowed a precise interpretation of the subtalar ligamentous support as anatomically described. A complementary clinical MRI study was performed which allowed the validation of "the inversion test": this test optimizes the visualization of the different ligamentous structures. Relative to the difficulties of conventional imaging procedures, MRI appears of clinical relevance in the diagnosis of subtalar instabilities. This technique allows direct visualization of ligaments (or their rupture) and therefore a better evaluation of subtalar involvement in ankle sprain. This paper present a functional concept in MRI articular ligamentous restraints concern.
距下关节不稳的诊断在临床和影像学上都仍然困难。作者展示了一项关于距下关节韧带支撑结构的解剖学和MRI研究。解剖学研究包括对15例冷冻保存的后足进行解剖和切片，精确了距下关节外侧（跗骨窦）和中央（跗骨管）腔室中韧带束的组织结构，主要由三层的下伸肌支持带、颈距跟韧带和距跟骨间韧带组成。根据定义的切片类型（矢状面、冠状面、冠状斜位、轴向横断面）对解剖标本进行了MRI研究（1.5特斯拉）。解剖学和MRI切片的相关性使得能够如解剖学描述那样精确解释距下关节韧带支撑结构。进行了一项补充性临床MRI研究，验证了“内翻试验”：该试验优化了不同韧带结构的可视化。相对于传统成像程序的困难，MRI在距下关节不稳诊断中具有临床相关性。这项技术能够直接观察韧带（或其断裂情况），从而更好地评估距下关节在踝关节扭伤中的受累情况。本文提出了一个关于MRI关节韧带限制的功能概念。
