■外侧踝关节稳定手术需要可靠的地标和距韧带附件的精确距离。下胫腓前韧带(AITFL)的远端束已用于定位腓骨上的前距腓骨韧带(ATFL)或跟腓骨韧带(CFL)的中心。然而,没有解剖学研究来验证AITFL的远端束作为踝关节外侧韧带稳定的标志,更重要的是,从ATFL或CFL附件到AITFL远端束的确切距离未知.
■本研究使用了16个没有踝关节损伤史的冷冻尸体标本(8个配对标本)。确认每个标本中是否存在AITFL的远端束。然后,测量了从AITFL远端束的最远端插入到腓骨上ATFL和CFL的足迹中心的距离.所有测量均由2名观察者进行,并通过组内相关系数(ICC)分析观察者内和观察者间的可靠性。
■在所有标本(100%)中均发现了AITFL的远端束。从AITFL的远端束的最远端插入到ATFL的足迹中心的平均距离,CFL,腓骨上两条韧带的交点中心为6.0至7.1毫米,11.5至13.2毫米,和9.0到10.0毫米,分别。在这些距离的解剖测量中显示了出色的观察者间和观察者内一致性(所有ICC>0.9,P<0.01)。
■在这项尸体研究中,我们发现远端束是踝关节外侧AITFL的恒定结构。从AITFL远端肌束的最远端插入到韧带脚印中心的距离是可靠的,可用于识别ATFL和CFL的起源以重建踝关节外侧韧带。
■这项解剖研究验证了AITFL的远端束作为潜在的里程碑,更重要的是,通过解剖测量确定从AITFL的远端束到踝关节外侧韧带附着中心的距离范围。该数据可用于识别用于外侧踝关节稳定手术的ATFL和CFL,并且对于内窥镜或关节镜技术变得特别有价值。
A reliable
landmark and precise distances from the ligament attachments are needed for lateral ankle stabilization surgery. The distal fascicle of the anterior inferior tibiofibular ligament (AITFL) has been used to locate the anterior talofibular ligament (ATFL) or calcaneofibular ligament (CFL) centers on the fibula. However, there is no anatomic study to validate the distal fascicle of the AITFL as a
landmark of lateral ankle ligament stabilization, and more importantly, the exact distances from the ATFL or CFL attachments to the distal fascicle of the AITFL are unknown.
Sixteen frozen cadaveric specimens (8 paired specimens) with no previous history of ankle injury were used in this study. Whether the distal fascicle of AITFL was present in each specimen was confirmed. Then, the distances from the most distal insertion of the AITFL\'s distal fascicle to the footprint centers of the ATFL and CFL on the fibula were measured. All measurements were performed by 2 observers, and the intraobserver and interobserver reliabilities were analyzed by intraclass correlation coefficients (ICCs).
The distal fascicle of the AITFL was found in all specimens (100%). The mean distance from the most distal insertion of the AITFL\'s distal fascicle to the footprint centers of the ATFL, CFL, and the intersection center of the 2 ligaments on the fibula was 6.0 to 7.1 mm, 11.5 to 13.2 mm, and 9.0 to 10.0 mm, respectively. Excellent interobserver and intraobserver agreement (all ICCs > 0.9, P < .01) was shown in the anatomic measurements of these distances.
In this cadaveric study, we found that the distal fascicle was a constant structure of the AITFL in the lateral ankle. The distances from the most distal insertion of the AITFL\'s distal fascicle to the ligamentous footprint centers were reliable and may be used to identify the origins of the ATFL and CFL for lateral ankle ligament reconstruction.
This anatomic study validates the AITFL\'s distal fascicle as a potential
landmark and, more importantly, determines the range of distances from AITFL\'s distal fascicle to the attachment centers of lateral ankle ligaments by anatomic measurements. The data may be used to identify the ATFL and CFL for lateral ankle stabilization surgery and become particularly valuable for endoscopic or arthroscopic techniques.