Abstract:
Understanding the anatomy of the calcaneocuboid (CCJ) remains essential when selecting staple fixation to optimize osseous purchase during rearfoot procedures. This anatomic study quantitatively describes the CCJ in relation to staple fixation sites. The calcaneus and cuboid from 10 cadavers were dissected. Widths at 5 mm and 10 mm increments away from the joint were measured in dorsal, midline, and plantar thirds of each bone. The widths between each position\'s 5 mm and 10 mm increments were compared using the Student\'s t test. The widths among the positions at both distances were compared using an ANOVA then post hoc testing. Statistical significance was set at p ≤ 0.05. The middle (23 ± 3 mm) and plantar third (18 ± 3 mm) of the calcaneus at the 10 mm interval was greater than the 5 mm interval (p = .04). At 5 mm distal to the CCJ, the dorsal third of the cuboid maintained a statistically significant greater width than the plantar third (p = .02). The 5 mm (p = .001) and 10 mm (p = .005) dorsal calcaneus widths as well as the 5 mm (p = .003) and 10 mm (p = .007) middle calcaneus widths were significantly greater than the plantar widths. This investigation supports the use of 20 mm staple 10 mm away from the CCJ in dorsal and midline orientations. Care should be taken when placing a plantar staple within 10 mm proximal to the CCJ as the legs may extend beyond the medial cortex compared to dorsal and midline placements.
摘要:
在选择钉固定以优化后足手术期间的骨购买时,了解跟骨(CCJ)的解剖结构仍然至关重要。这项解剖学研究定量描述了与钉固定部位有关的CCJ。解剖了10具尸体的跟骨和长方体。在背侧测量距关节5毫米和10毫米的宽度,中线,和每根骨足底的三分之一。使用Studentt检验比较每个位置的5mm和10mm增量之间的宽度。使用ANOVA然后事后测试比较两个距离处的位置之间的宽度。统计学显著性设定为p≤0.05。跟骨的中部(23±3mm)和足底三分之一(18±3mm)在10mm的间隔大于5mm的间隔(p=.04)。在距离CCJ5毫米处,长方体背三分之一的宽度比足底三分之一的宽度有统计学意义(p=.02)。5mm(p=.001)和10mm(p=.005)背侧跟骨宽度以及5mm(p=.003)和10mm(p=.007)中部跟骨宽度显着大于足底宽度。这项研究支持在背侧和中线方向上使用距CCJ10mm的20mm订书钉。在靠近CCJ的10mm范围内放置足底钉时应格外小心,因为与背侧和中线放置相比,腿可能会延伸到内侧皮质之外。