基于CT平扫下胫腓联合腓骨切迹分型及其临床意义

尹诗琴; 杨思艺; 王锐涵; 游贵宣; 杨迎秋; 张磊

doi:10.16098/j.issn.0529-1356.2024.01.012

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解剖学报 ›› 2024, Vol. 55 ›› Issue (1) : 82-87. DOI: 10.16098/j.issn.0529-1356.2024.01.012

解剖学

基于CT平扫下胫腓联合腓骨切迹分型及其临床意义

尹诗琴¹ 杨思艺²王锐涵^1,3 游贵宣¹杨迎秋² 张磊^4,5*

作者信息 +

Distal tibiofibular syndesmosis fibular notch typing and its clinical significance based on CT

YIN Shi-qin¹ YANG Si-yi² WANG Rui-han^1,3 YOU Gui-xuan¹ YANG Ying-qiu² ZHANG Lei^4,5*

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文章历史 +

摘要

目的基于CT下胫腓联合腓骨切迹形态学分型及其临床意义。方法根据纳入排除标准分析在骨伤科行踝关节CT检查患者（男性123例，女性102例，均为汉族，年龄18~60岁）的图像资料，按形态学特点对下胫腓联合腓骨切迹进行分型，并测量下胫腓联合腓骨切迹周围的8个距离。结果回顾分析了2013年12月~2022年12月225例患者结果，可将下胫腓联合腓骨切迹分为4型：C形（50.67%）、V形（26.67%）、平坦形（15.11%）、L形（7.56%）。平坦形的切迹前后部夹角（145.56 ± 9.25）°最大（P<0.05），L形切迹前后部夹角（125.07 ± 13.54）°最小（P<0.05）；平坦形的切迹深度（3.11 ± 0.83）mm最小（P<0.05），L形的切迹深度（4.47 ± 1.11）mm最大（P<0.05）。左侧切迹后部长度（13.06 ± 3.56）mm、胫腓前间隙（3.83 ± 1.49）mm明显大于右侧（P<0.05）；男性切迹后部长度（13.36 ± 3.46）mm、切迹深度（3.93 ± 1.10）mm及胫腓重叠垂直距离（9.10 ± 2.55）mm明显大于女性（P<0.05）。结论通过测量下胫腓联合腓骨切迹相关数据并根据形态将其分为4种类型。平坦形下胫腓联合腓骨切迹更易出现慢性踝关节不稳，在解剖复位时更易发生腓骨前移；而L形和C形切迹的下胫腓联合在解剖复位时更易发生腓骨后移或旋转复位不良。

Abstract

Objective To investigate the morphological typing and clinical significance of the distal tibiofibular syndesmosis fibular notch based on CT images. Methods According to the inclusion and exclusion ceiteria, the imaging data of patients undergoing ankle joint CT examination were analyzed, and the inferior tibiofibular joint fibula notch was classified according to the morphological characteristics. The measurements included 8 distances. There were 123 males and 102 females, all of whom were Han nationality, aged 18-60 years old. Results Retrospectively analyzed the result of 225 patients from December 2013 to December 2022. The distal tibiofibular syndesmosis fibular notch was divided into four types according to morphological characteristics, C-shaped (50.67%), V-shaped (26.67%), flat-shaped (15.11%) and L-shaped (7.56%). The angle between the anterior and posterior facets of the flat shape (145.56 ± 9.25)° was the largest and the angle between the anterior and posterior facets of the L shape (125.07 ± 13.54)° was the smallest(P<0.05); the depth of the notch in the flat shape (3.11 ± 0.83) mm was the smallest and in the L shape (4.47±1.11) mm was the largest(P<0.05);The posterior facet length (13.06 ± 3.56) mm and anterior tibiofibular gap (3.83±1.49) mm on left were larger than on the right side (P<0.05); The posterior facet length (13.36 ± 3.46) mm, fibular notch depth (3.93 ± 1.10) mm and vertical distance of tibiofibular overlap (9.10 ± 2.55) mm larger in men than in women (P<0.05). Conclusion In this study, the data related to the inferior tibiofibular syndesmosis notch were measured and divided into four types according to the shape. The flat inferior tibiofibular syndesmosis notch is more likely to have chronic ankle instability, and the fibula is more likely to move forward during anatomical reduction. The inferior tibiofibular syndesmosis of L-shaped and C-shaped notches is more prone to posterior displacement of fibula or poor rotation reduction during anatomical reduction.

导出引用

尹诗琴杨思艺王锐涵游贵宣杨迎秋张磊. 基于CT平扫下胫腓联合腓骨切迹分型及其临床意义[J]. 解剖学报. 2024, 55(1): 82-87 https://doi.org/10.16098/j.issn.0529-1356.2024.01.012

YIN Shi-qin YANG Si-yi WANG Rui-han YOU Gui-xuan YANG Ying-qiu ZHANG Lei. Distal tibiofibular syndesmosis fibular notch typing and its clinical significance based on CT[J]. Acta Anatomica Sinica. 2024, 55(1): 82-87 https://doi.org/10.16098/j.issn.0529-1356.2024.01.012

中图分类号： R445.2

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