下胫腓联合韧带损伤与体位关系的生物力学研究  

The inferior tibiofibular syndesmosis ligaments' injury and the ankle position:biomechanical study

作　　者：邹明[1] 张焱[2] 柏广富[1] 骆宇春[1] 刘树坤[2] 赵卫东[3] 

机构地区：[1]安徽医科大学无锡临床学院,江苏无锡214044 [2]解放军第101医院骨科,江苏无锡214044 [3]南方医科大学广东省医学生物力学重点实验室,广州510515

出　　处：《中国临床解剖学杂志》2012年第4期443-446,共4页Chinese Journal of Clinical Anatomy

基　　金：南京军区重点基金项目(09Z003)

摘　　要：目的对下胫腓联合韧带损伤与体位的关系进行生物力学研究,探讨下胫腓联合各韧带在踝关节何种体位上更容易损伤。方法 8只(左、右各4只)新鲜成人小腿,完全暴露下胫腓联合各韧带后自踝关节上方20 cm横断,上端用牙托粉包埋模拟上胫腓关节。足底自跟骨前方横断,保留距下、距舟、跟骰关节,同样用牙托粉平行足底板包埋置于生物材料实验系统上。固定踝关节于中立、背伸(15°)、跖屈(20°)、内翻(15°)、外翻(20°)、内旋(10°)、外旋(5°)7个体位,逐步缓慢轴向加载500N和外旋方向5N.m扭矩后测出各韧带相对于中立位未受力时的长度变化,计算出各韧带的应变。结果下胫腓前韧带在踝关节处于内翻、跖屈位时应变最大和次最大,分别为(0.1294±0.0030)、(0.1150±0.0018);下胫腓骨间韧带也在踝关节处于内翻、跖屈位时应变最大和次最大,分别为(0.1331±0.0030)、(0.1138±0.0053);下胫腓后韧带(包括深层的下胫腓横韧带)亦在踝关节处于内翻、跖屈位时应变最大和次最大,分别为(0.0427±0.0016),(0.0285±0.0015),统计分析具有显著性差异(P<0.05)。结论下胫腓前韧带在内翻位或内翻、跖屈复合体位(即旋后位)时应变最大因此受力最大更易损伤,同理下胫腓骨间韧带、后韧带也均在内翻位或旋后位时更易损伤。Objective To explore biomechanical features of the tibiofibular syndesmosis ligaments, and the ankle position which induce the injury of ligaments easily. Methods 8 （left 4, right 4） flesh adult leg specimens were used in this study. The tibiofibular syndesmosis ligaments were completely exposed and cut horizontally above the ankle about 20cm. The top of ligaments was embedded with denture powder for simulating the top tibiofibular joint, as well, the bottom was also embedded and fixed on material experimental machine, after cutting from calcaneal bone, keeping subtalar, talonavicular and calcaneocuboid joints. At the different positions, involving neutral position, dorsifiexion （15°）, plantarflexion （20°）, varus （15°）, valgus （20°）, internal rotation （10°） and external rotation （5°）, the length and stress changes of ligaments after loading with the axial 500N and external rotation torque （5N.m）, were analyzed. Results At the position of introversion and plantarflexion, the significant stress changes of inferior and anterior tibiofibular ligaments, the interosseous ligament, and the posterior ligament（ Including the deep transverse ligament） appeared, as （0.1294±0.0030） and （0.1150±0.0018）,（0.1331 ±0.0030） and （0.1138±0.0053）, （0.0427±0.0016） and（0.0285±0.0015） respectively. Conclusions At the position of introversion and plantarflexion, the inferior and anterior tibiofibular ligament, the interosseous ligament, and the posterior ligament easy to be damaged, for those ligaments endure the largest stress.

关 键 词：下胫腓联合韧带 踝关节体位 生物力学 

分 类 号：R322.73[医药卫生—人体解剖和组织胚胎学]