跟骨骨折内固定治疗的应用解剖研究  

Applied anatomical research of fixation of calcaneal fractures

作　　者：赖桂华[1] 俞鹏[1] 刘宏升[1] 刘扬[2] 陈刘成[2] 陈士文[1] 

机构地区：[1]蚌埠医学院人体解剖学教研室,安徽蚌埠233030 [2]蚌埠医学院第一附属医院,安徽蚌埠233030

出　　处：《泰山医学院学报》2016年第8期846-847,共2页Journal of Taishan Medical College

基　　金：安徽省重点实验室;工程中心(蚌埠医学院)开放课题计划;项目编号BYKL1401ZD

摘　　要：目的为跟骨骨折螺钉植入内固定治疗提供必要的应用解剖依据。方法随机抽取24例正常成年人跟骨干燥标本,利用游标卡尺和量角器进行测量分析,对跟骨跟骰关节面的内倾角及横径进行测定,对跟骨的矢状断层切面及关节面内部骨小梁结构进行观察,了解骨小梁的骨密度分布情况,找出螺钉植入的最佳位置。结果本次研究选择的24例成年人跟骨标本的内倾角在43.2°-72.5°之间,平均为59.7°±5.9°,横径在19.04-27.15mm之间,平均（23.51±2.04）mm,跟骰关节面紧邻的骨小梁较为致密,厚度在5 mm左右,后方和下方的骨小梁密度逐渐降低。结论跟骰关节面下方紧邻关节面的骨小梁密度较高,可作为螺钉植入的最佳位置,螺钉长度的选择要充分考虑患者跟骨跟骰关节面横径长度,并根据内倾角选择进钉方向,提高固定效果。Objective： To provide anatomical basis for the necessary application calcaneal fracture fixation screw implantation. Methods ： 24 randomly selected adults with normal calcaneus dried specimens, use a protractor and vernier caliper measurement and analysis, and the inclination of the inner diameter of the calcaneus with the cuboid articular surface was measured to observe the calcaneus sagittal slice of the articular surface of the interior trabecular structure was observed to understand the distribution of trabecular bone density, find the best position screws implanted. Results： This study se- lected 24 cases within the calcaneus inclination adult specimens between 43.2 °- 72. 5°, an average of 59.7°± 5.9°,19. 04mm - 27. 15ram in diameter between the average （23.51 ± 2. 04 ） ram, calcaneocuboid articular surface adjacent trabecular bone is more dense thickness of about 5mm, trabecular bone density decreases and below the rear. Conclusion： with the articular surface close to the bottom of the dice higher trabecular bone density of the articular surface, as the best place to screw implants and choose the length of the screw to fully consider patients with ealcaneal cuboid articular surface diameter length, and according to internal dip Select into the nail towards improving the anchoring effect.

关 键 词：跟骨骨折 内固定 跟骰关节 应用解剖 

分 类 号：R687.3[医药卫生—骨科学] R322.7[医药卫生—外科学]