摘要
目的 应用CT三维重建为载距突体表定位,并测量跟骨外侧壁指定点向载距突置钉角度及螺钉长度,为跟骨手术提供理论依据。方法 选用30个成人足踝部湿性标本,使用螺旋CT扫描并三维重建,观察测量找到载距突体表定位的新方法;CT扫描40只成人跟骨干性标本,利用软件分别测量载距突中点与跟骨外侧壁指定点之间的线段的角度和长度。结果 在踝关节功能位下,以足内侧面定为“矢状参考面”测量,内踝前缘与载距突前缘在同一冠状面上,经内踝前缘的垂线与过载距突前缘冠状线相交于一点,该点与内踝前缘的垂直距离为（34.95±2.60）mm,载距突长度为（21.44±1.89）mm,高度为（10.17±1.16）mm,载距突前倾角为（35.31±3.73）°。自跟骨外侧壁找到6个具有代表性的测量点,其与载距突连线测量结果如下：在跟骨前部,G、E两点上倾角分别为（28.78±3.90）°、（29.47±2.96）°,前倾角分别为（-19.83±4.60）°（-11.02±4.74）°;在后关节面下方,C、K、I、J 4点上倾角为（2.52±2.46）°、（2.92±2.28）°、（14.98±2.49）°、（14.38±1.90）°,前倾角分别为（7.32±1.66）°、（19.25±1.98）°、（10.30±2.63）°、（19.33±1.97）°。置入螺钉的长度在40-44mm,C点最小,G点最大。结论 在踝关节功能位下以内踝前缘做标志,可以在体表定位载距突;利用CT及工作站软件可以准确测量自跟骨外侧壁各点到载距突的角度和长度。
Objective To use CT and 3Dreconstruction technique to locating mark of sustentaculum tali,and measure the angle length of the specified point of the lateral wall of the calcaneus to sustentaculum tali for providing.To basis for the operation of calcaneus.Methods Thirty adult ankle wet specimens were chosen and scanned with CT,and the dicom data were converted into the software to 3D-reconstruction,the observation and measurement to find new methods of locating mark of sustentaculum tali;Forty adult calcaneus dried specimens were chosen and scanned with CT.The dicom data were converted into the software to 3D-reconstruction,using a workstation software measure the angle and length of the line which from the center of the sustentaculum tail to each point on the calcaneal lateral wall.Results First,in the function of ankle joint position,with the foot medial surface as＂sagittal reference plane＂measurement,the vertical line passing through the leading edge of medial malleols and the coronal line passing through the leading edge of sustentaculum tali intersect at a point.The vertical distance of the point to leading edge of medial malleols was（34.95±2.60）mm,the length of sustentaculum tali was（21.44±1.89）mm,the height of sustentaculum tali was（10.17±1.16）mm,the anteversion of sustentaculum tali was（35.31±3.73）°.Second,in front of calcaneus,upward angel of points G,E were（28.78±3.90）°,（29.47±2.96）°respectively.Frontward angle of points G,E were（-19.83±4.60）°,（-11.02±4.74）°respectively.Under the posterior articular surface,upward angel of points C,K,I,J were（2.52±2.46）°,（2.92±2.28）°,（14.98±2.49）°,（14.38±1.90）°respectively.Frontward angle of points C,K,I,J were（7.32±1.66）°,（19.25±1.98）°,（10.30±2.63）°,（19.33±1.97）°respectively.The length of screw was about 40-44 mm.The length of C point to the sustentaculum tail was minimum,and the length of G was maximum.Conclusion In the function of ankle joint position,the sustentaculum tail can be located with the leading edge of medial malleols as a surface landmarks.The measurement of the angle and length of which from each point on the calcaneal lateral wall to sustentaculum tail by using CT.
出处
《重庆医学》
CAS
北大核心
2015年第28期3966-3968,共3页
Chongqing medicine
基金
河北省卫生厅科研基金项目(20130027)
关键词
载距突
切开复位内固定术
体层摄影术
X线计算机
内踝前缘
sustentaculum tali
open reduction and internal fixation
tomography
X-ray computed
leading edge of medial malleols
