外踝失稳对胫距关节接触面的影响  

Influence of loss of lateral malleolar stability on tihotdar contact sur-face

作　　者：罗映晖[1] 林元问[1] 张郢华[1] 

机构地区：[1]南京铁道医学院解剖学教研室

出　　处：《中国临床解剖学杂志》1994年第4期310-311,共2页Chinese Journal of Clinical Anatomy

摘　　要：在１９例标本上，观察了负重时胫距关节在四种不同情况下，接触面积大小及图形变化趋势，实验结果表明：正常胫距关节平均接触面积为４５５．０±９１．２ｍｍ￣２，接触区似“７”字形，前部呈横向条带，外侧部为稍倾斜的纵向条带；腓骨切除和外踝韧带切断虽不会造成接触面积明显缩小，但可致接触区图形变化，即接触区中部至非接触区的距离增大；距骨外移１ｍｍ，胫距关节接触面积明显缩小．提示：外踝失稳导致踝关节退行性变的机制，除接触面积缩小，局部压应力骤升外，在无明显距骨外移时，类似冲击负荷对软骨的损害可能起主导作用。n 19 specimens,the size and shape of contact surface of tibiotalar joint in weight-bearingstate were observed in four different conditions. The results show that the average contact area ofthe joint in anatomical posture is 455. 0±91. 2mm￣2,and its shape resembles the letter“7”.Resect-ing fibula and lateral ligament of ankle will not cause a marked reduction of tibiotalar contactarea,but may increase the distance from the middle part of the contact surface to noncontactingarea. When talus moves lmm laterally the tibiotalar contact surface will be apparently reduced.Based on these results,it is suggested that besides reduction in contact area and sudden increase oflocal pressing stress, the mechanism of retrograde degeneration due to loss of lateral malleolarstability is similar to of the impact injury on articular cartilage,and the latter may play an impor-tant role when there is no obvious lateral shifting of talus.

关 键 词：胫距关节 生物力学 接触面 

分 类 号：R318.01[医药卫生—生物医学工程]