下胫腓联合损伤对踝关节稳定性影响的生物力学研究  

Impact of syndesmotic injury on the biomechanical stability of ankle joint

作　　者：毕刚[1] 陈大伟[1,2] 李春光 李兵[1] 杨云峰[1] 张东升[3] 俞光荣[1] 

机构地区：[1]同济大学附属同济医院骨科,上海200065 [2]复旦大学附属浦东医院骨科 [3]上海大学理学院力学系

出　　处：《中国矫形外科杂志》2017年第20期1881-1885,共5页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:81501884)

摘　　要：[目的]探讨下胫腓联合损伤对踝关节稳定性的生物力学影响。[方法]采用6例新鲜尸体标本,制作踝关节旋前外旋损伤模型,逐步离断下胫腓联合各韧带、骨间膜和三角韧带。对标本进行600 N轴向加载,同时对踝关节施加扭矩为5 Nm的外旋力。测量下胫腓联合不同程度损伤情况下,下胫腓联合的相对位移和踝关节外旋扭转角度。[结果]随着下胫腓联合韧带和三角韧带的序贯性离断,下胫腓联合的远端腓骨相对内外位移、前后位移、腓骨转角以及踝关节扭转角度呈逐渐增加趋势。[结论]下胫腓联合韧带维持踝关节稳定。在旋转稳定性方面,下胫腓后韧带的作用最为突出。下胫腓联合韧带离断后,再离断三角韧带,踝关节的稳定性进一步丢失。[Objective] To explore the impact of syndesmotic injury on the stability of ankle joint. [Methods] Six fresh frozen cadaveric specimens were used to make a biomechanical testing. The specimens were amputated above the knee joint. Ligaments of the syndesmosis, interosseous membrane, and deltoid ligament were sequentially sectioned. The specimens were loaded under a combination of 600 N axial loading and 5 Nm external rotation loading. Motion of the syndesmosis and the external rotation angle of the ankle joint were measured. [Results] Sequential resection of the syndesmotic ligaments and deltoid ligament led to increase of the medial-lateral displacement, anterior-posterior displacement, and rotation angle （around its axis） of the distal fibula, as well as the external rotation angle of the ankle joint. [ Conclusions ] The syndesmosis takes an important part in maintaining the biomechanical stability of the ankle joint. The posterior tibiofibular ligament seems to be the most important syndesmosis ligament for the rotational stability of the ankle joint. Dissection of the deltoid ligament would make the ankle joint much more unstable following the syndesmosis resection.

关 键 词：下胫腓联合 踝关节 生物力学 

分 类 号：R318.01[医药卫生—生物医学工程] R684[医药卫生—基础医学]