跖肌腱解剖与生物力学特征及在韧带重建中的应用  

Anatomical and biomechanical characteristics of plantaris tendon and its application inligament reconstruction

作　　者：钟世江 徐桂军[2] 赵嘉国 ZHONG Shijiang;XU Guijun;ZHAO Jiaguo(Graduate School,Tianjin University of Traditional Chinese Medicine,Tianjin,300193,P.R.China;Department of Foot and Ankle Surgery,Tianjin Hospital,Tianjin,300211,P.R.China;Department of Foot and Ankle Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing,100176,P.R.China)

机构地区：[1]天津中医药大学研究生院,天津300193 [2]天津市天津医院足踝外科,天津300211 [3]首都医科大学附属北京同仁医院足踝外科中心,北京100176

出　　处：《中国修复重建外科杂志》2024年第2期234-239,共6页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的 总结跖肌腱解剖特点、生物力学特征、切除方式以及在韧带重建中的应用,提高其临床利用度。方法 查阅国内外关于跖肌腱解剖、生物力学及其在韧带重建中应用的研究文献,并进行系统归纳总结。结果 解剖研究显示跖肌腱存在缺失情况,大部分跖肌腱呈扇形在跟腱前、内侧止于跟骨结节。不同股数的跖肌腱生物力学参数存在明显差异,多股跖肌腱相较于单股有明显优势。跖肌腱的切取方式可分为近端和远端两种,在切取前需确保周围无明显解剖变异和粘连。目前,跖肌腱多用于踝关节周围韧带重建或跟腱断裂缝合加强,临床疗效满意;用于上肢和膝关节韧带重建的研究较少。结论 跖肌腱位置相对表浅、容易切取,切取后对局部功能影响较小,可用于踝关节周围韧带重建或跟腱断裂缝合加强,但能否作为上肢和膝关节韧带重建自体移植物有待进一步研究。Objective To improve the clinical utility of the plantaris tendon mainly by summarizing its anatomical characteristics,biomechanical properties,harvesting methods,and its applications in ligament reconstruction.Methods The relevant literature from domestic and international databases regarding the anatomical and biomechanical characteristics of the plantaris tendon and its applications in ligament reconstruction was comprehensively reviewed and systematically summarized.Results The plantaris tendons have an absence.The majority of plantaris tendon forms a fan-shape on the anterior and medial sides of the Achilles tendon and terminates at the calcaneal tuberosity.There are significant differences in biomechanical parameters between plantaris tendon with different numbers of strands,and multi strand plantaris tendon have significant advantages over single strand tendon.The plantaris tendon can be harvested through proximal and distal approaches,and it is necessary to ensure that there are no obvious anatomical variations or adhesions in the surrounding area before harvesting.The plantaris tendon is commonly utilized in ligament reconstruction around the ankle joint or suture reinforcement for Achilles tendon rupture,with satisfactory effectiveness.There is limited research on the use of plantar tendon in the reconstruction of upper limb and knee joint ligaments.Conclusion The plantaris tendon is relatively superficial,easy to be harvested,and has less impact on local function.The plantaris tendon is commonly utilized in ligaments reconstruction around the ankle joint or suture reinforcement for Achilles tendon rupture.The study on the plantaris tendon for upper limbs and knee joints ligament reconstruction is rarely and require further research.

关 键 词：跖肌腱 韧带重建 自体移植 生物力学 应用解剖 

分 类 号：R687.4[医药卫生—骨科学]