跟骨上腓骨肌滑车的解剖形态学分型及临床意义  

Anatomical morphologic classification of the peroneal trochlea on the calcaneus and its clinicalsignificance

作　　者：张磊 陈旭 陈鳕夷 吴王玉 熊彬 石厚银 汪国友 Zhang Lei;Chen Xu;Chen Xueyi;Wu Wangyu;Xiong Bin;Shi Houyin;Wang Guoyou(Department of Orthopedics,The Affiliated Traditional Chinese Medicine Hospital,Southwest Medical University,Luzhou 646000,Sichuan Province,China;Center for Orthopedic Diseases Research,The Affiliated Traditional Chinese Medicine Hospital,Southwest Medical University,Luzhou 646000,Sichuan Province,China;Luzhou Key Laboratory of Orthopedic Disorders,Luzhou 646000,Sichuan Province,China;Department of Pediatrics,Southwest Medical University,Luzhou 646000,Sichuan Province,China;School of Clinical Medicine,Southwest Medical University,Luzhou 646000,Sichuan Province,China;School of Traditional Chinese and Western Medicine,Southwest Medical University,Luzhou 646000,Sichuan Province,China)

机构地区：[1]西南医科大学附属中医医院骨伤科,四川泸州646000 [2]西南医科大学附属中医医院骨伤疾病研究中心,四川泸州646000 [3]骨伤疾病泸州市重点实验室,四川泸州646000 [4]西南医科大学儿科学系,四川泸州646000 [5]西南医科大学临床医学院,四川泸州646000 [6]西南医科大学中西医结合学院,四川泸州646000

出　　处：《中国临床解剖学杂志》2024年第6期649-654,共6页Chinese Journal of Clinical Anatomy

基　　金：2022年四川省科技计划联合创新专项项目(2022YFS0609);2022年西南医科大学附属中医医院科研团队培育项目(2022-CXTD-08);2023年度四川省中医药管理局中医药科研专项课题面上项目(中医药基础)(2023MS248);2023年度泸州市科技计划项目(科技创新领军人才)(2023RCX172);2023年西南医科大学中西医结合专项(优基计划)(2023ZYYJ03)。

摘　　要：目的 通过对跟骨上腓骨肌滑车的形态学分型,探讨其临床意义。方法 2014年7月至2023年2月,本回顾性研究纳入215人,由西南医科大学附属中医医院骨伤科提供。根据腓骨肌滑车形态进行分型,分别测量高度、长度、与周围结构的相对位置以及切除角度。结果 166例(77.2%)跟骨显示腓骨肌滑车。腓骨肌滑车形态可分为4型:平坦形12例(7.2%),圆锥形73例(44.0%),直脊形74例(44.6%),鹰嘴形7例(4.2%)。腓骨肌滑车中点到跟骨后表面距离和高度在性别间均无统计学意义(P>0.05)。直脊形和鹰嘴形高度显著高于圆锥形(P<0.05)。同时,圆锥形高度显著高于平坦形(P<0.05)。圆锥形长度明显短于其他分型(P<0.05)。圆锥形的腓骨肌滑车中点到第五跖骨粗隆的距离和到跟骰关节面外侧中点的距离显著长于直脊形(P<0.05)。圆锥形的腓骨肌滑车中点到跟骨后侧面之间的距离明显小于直脊形(P<0.05)。结论 本研究提供了腓骨肌滑车的分型、尺寸与位置的进一步信息,可为临床诊治增生腓骨肌滑车提供解剖学基础,避免盲目切除而造成腓骨肌腱的损伤。Objective To investigate the morphological classification of the peroneal trochlea,and to explore its clinical significance.Methods From July 2014 to February 2023,215 people were included in this retrospective study,which was provided by Department of Orthopedics,The Affiliated Traditional Chinese Medicine Hospital,Southwest Medical University.The peroneal trochlea was classified according to its morphology and the height,length,relative position to the surrounding structures and the excision angle were measured,respectively.Results The calcaneus of 166(77.2%)cases showed peroneal trochlea.The morphology of the peroneal trochlea could be divided into 4 types:flat type in 12 cases(7.2%),conicalness type in 73 cases(44.0%),straight ridge type in 74 cases(44.6%),and olecranon-type in 7 cases(4.2%).There was no statistical significancein height and distance from the midpoint of peroneal trochlea to posterior surface of calcaneus between genders(P>0.05).The height of straight ridge type and olecranon-type were significantly higher than that of the conicalness type(P<0.05).Meanwhile,the height of conicalness type was significantly higher than that of the flat type(P<0.05).The length of conicalness type was significantly shorter than that of other types(P<0.05).The distance between the midpoint of peroneal trochlea and the fifth metatarsal tuberosity and the lateral midpoint of calcaneocuboid articular surface of conicalness type wassignificantly longer than that of straight ridge type (P<0.05). The distance between the midpoint of peronealtrochlea and the posterior surface of calcaneus of conicalness type was significantly shorter than that ofstraight ridge type (P<0.05). Conclusions This study provides further information on the classification, sizeand location of the peroneal trochlea, which may present anatomical basis for clinical diagnosis and treatmentof hyperplastic peroneal trochlea, to avoid blind resection of the peroneus tendon injury.

关 键 词：腓骨肌滑车 解剖形态学 CT 

分 类 号：R323.72[医药卫生—人体解剖和组织胚胎学]