基于踝关节正位X射线的外踝放射学研究及其临床意义

张程; 丁文谦; 郑国涛; 谢晨学; 李阳; 边劲松

doi:10.11659/jjssx.12E022038

您当前的位置：

首页 >

文章列表页 >

基于踝关节正位X射线的外踝放射学研究及其临床意义

临床研究 | 更新时间：2023-09-26

- 基于踝关节正位X射线的外踝放射学研究及其临床意义
- Radiologic study of lateral malleolus and their clinical significances:a research based on anteroposterior X-ray of ankle
- 局解手术学杂志 2023年32卷第9期页码：821-824
- 作者机构：
  
  1.沧州市人民医院关节运医科，河北沧州 061000
  2.沧州市人民医院院感科，河北沧州 061000
  3.沧州市人民医院影像科，河北沧州 061000
- 作者简介：
  
  边劲松，E-mail：bjs0183@163.com
- 基金信息：
  
  河北省医学科学研究课题计划(20211309)
- DOI：10.11659/jjssx.12E022038
  中图分类号： R274.12;R686.5
- 纸质出版日期：2023-09-25，
  
  收稿日期：2022-12-06，
扫描看全文
张程,丁文谦,郑国涛等.基于踝关节正位X射线的外踝放射学研究及其临床意义[J].局解手术学杂志,2023,32(09):821-824.

ZHANG Cheng,DING Wen-qian,ZHENG Guo-tao,et al.Radiologic study of lateral malleolus and their clinical significances:a research based on anteroposterior X-ray of ankle[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(09):821-824.
张程,丁文谦,郑国涛等.基于踝关节正位X射线的外踝放射学研究及其临床意义[J].局解手术学杂志,2023,32(09):821-824. DOI： 10.11659/jjssx.12E022038.

ZHANG Cheng,DING Wen-qian,ZHENG Guo-tao,et al.Radiologic study of lateral malleolus and their clinical significances:a research based on anteroposterior X-ray of ankle[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(09):821-824. DOI： 10.11659/jjssx.12E022038.

摘要

目的

通过对踝关节正位X射线的外踝特征进行观察分析和放射学测量，为外踝解剖复位提供量化标准。

方法

选取我院120名正常成人标准踝关节X射线正位片，观察踝关节X射线正位片上平行间隙、“硬币”征、Shenton线，并分析性别、年龄对这些指标的影响及相关性。测量并对比男女性的距小腿角、腓踝角、外踝垂直高度、内外踝高度差、下胫腓间隙宽度、下胫腓重叠宽度，分析外踝垂直高度与年龄的相关性。

结果

120例踝关节正位X射线中平行间隙阳性率为100%；性别、年龄对“硬币”征和Shenton线的阳性率影响不显著（

0.05）。男性和女性间距小腿角、腓踝角、下胫腓间隙宽度、下胫腓重叠宽度比较差异均无统计学意义（

0.05）；男性外踝垂直高度、内外踝高度差大于女性（

0.05）；男性、女性外踝垂直高度与年龄无相关性（

=-0.086、0.058，

=0.516、0.659）。

结论

在判断外踝解剖复位时，踝关节正位X线上的平行间隙、“硬币”征和Shenton线可作为踝穴位以外的一种补充，性别和年龄对其没有影响；在应用距小腿角、腓踝角、下胫腓间隙宽度、下胫腓重叠宽度作为外踝解剖复位参考标准时，无需考虑性别因素；而在应用外踝垂直高度、内外踝高度差作为成人外踝解剖复位参考标准时，需考虑性别，但外踝垂直高度无需考虑年龄因素。

Abstract

Objective

To observe and measure lateral malleolus in anteroposterior X-ray of ankle，in order to provide quantitative standard for the anatomical reduction of lateral malleolus.

Methods

The standard anteroposterior X-ray of ankle in 120 normal adults were selected. The parallel space， "coin" sign and Shenton line were observed on the anteroposterior X-ray of ankle， and the impact and correlation of gender and age on these indicators were analyzed.Then the talo-crural angle， fibular ankle angle， lateral ankle vertical height， medial and lateral ankle height difference， tibiofibular clear space width and tibiofibular overlap width of males and females were measured and compared，and the correlation between the lateral ankle vertical height and age was analyzed.

Results

The positive rate of parallel space in 120 cases of anteroposterior X-ray of ankle was 100%. The gender and age had no significant effect on the positive rates of the "coin" sign or the Shenton line （

0.05）. There was no significant difference in the talo-crural angle， fibular ankle angle ， tibiofibular clear space width or tibiofibular overlap width between males and females （

0.05）. The lateral ankle vertical height and medial and lateral ankle height difference of males were greater than those of females （

0.05）. There was no correlation between the lateral ankle vertical height and age in both males and females （

=-0.086，0.058；

=0.516，0.659）.

Conclusion

When evaluating the anatomical reduction of the lateral malleolus， the parallel space， "coin" sign and Shenton line in anteroposterior X-ray of ankle can be a supplement to the ankle mortise X-ray， and the gender and age have no effect on the above indicators. There is no need to consider gender when applying talo-crural angle， fibular ankle angle， tibiofibular clear space width and tibiofibular overlap width as reference standards for anatomical reduction of the lateral malleolus； when using lateral ankle vertical height， medial and lateral ankle height difference as the reference standards for anatomical reduction of adult lateral malleolus， gender should be considered， but the lateral ankle vertical height does not need to consider for age.

关键词

踝关节腓骨“硬币”征Shenton线X射线解剖复位

Keywords

anklefibula"coin" signShenton lineX-rayanatomical reduction

references

Sinha A，Sirikonda S，Giotakis N，et al.Fibular lengthening for malunited ankle fractures［J］.Foot Ankle Int，2008，29（11）：1136-1140.doi：10.3113/FAI.2008.1136http://dx.doi.org/10.3113/FAI.2008.1136.

Stürznickel J，Schmidt FN，Schfer HS，et al.Bone microarchitecture of the distal fibula assessed by HR-pQCT［J］.Bone，2021，151：1-8.doi：10.1016/j.bone.2021.116057http://dx.doi.org/10.1016/j.bone.2021.116057.

Yablon IG，Heller FG，Shouse L.The key role of the lateral malleolus in displaced fractures of the ankle［J］.J Bone Joint Surg Am，1977，59（2）：169-173.

Weber BG.Lengthening osteotomy of the fibula to correct a widened mortice of the ankle after fracture［J］.Int Orthop，1981，4（4）：289-293.doi：10.1007/BF00266071http://dx.doi.org/10.1007/BF00266071.

Sarkisian JS，Cody GW.Closed treatment of ankle fractures：a new criterion for evaluation-a review of 250 cases［J］.J Trauma，1976，16（4）：323-326.

Visser HJ，Malik K，Djali RA.Fibular-lengthening osteotomy to correct a malunited ankle fracture using fresh-frozen femoral head allograft［J］.J Am Podiatr Med Assoc，2017，107（4）：318-323.doi：10.7547/15-207http://dx.doi.org/10.7547/15-207.

Panchbhavi VK，Gurbani BN，Mason CB，et al.Radiographic assessment of fibular length variance：the case for "fibula minus"［J］.J Foot Ankle Surg，2018，57（1）：91-94.doi：10.1053/j.jfas.2017.08.013http://dx.doi.org/10.1053/j.jfas.2017.08.013.

Ju DG，Debbi EM，Neustein AZ，et al.Fibular lengthening osteotomy with revision syndesmotic repair for ankle fracture malunion［J］.J Orthop Trauma，2019，33（1）：38-39.doi：10.1097/BOT.0000000000001534http://dx.doi.org/10.1097/BOT.0000000000001534.

张宏宁，朱永展，李雪，等.踝关节骨折中外踝移位对胫距关节接触影响的三维有限元分析［J］.中华创伤骨科杂志，2017，19（9）：769-774.doi：10.3760/cma.j.issn.1671-7600.2017.09.007http://dx.doi.org/10.3760/cma.j.issn.1671-7600.2017.09.007.

Weber D，Weber M.Corrective osteotomies for malunited malleolar fractures［J］.Foot Ankle Clin，2016，21（1）：37-48.doi：10.1016/j.fcl.2015.09.003http://dx.doi.org/10.1016/j.fcl.2015.09.003.

邱伟建，王宁宁，曾源，等.滑动撑开技术配合解剖钢板矫正腓骨短缩和旋转畸形［J］.中国矫形外科杂志，2020，28（13）：644-646.doi：10.3977/j.issn.1005-8478.2020.13.18http://dx.doi.org/10.3977/j.issn.1005-8478.2020.13.18.

马富强，王爱国，王翔宇，等.腓骨截骨下胫腓联合融合治疗陈旧性踝关节骨折畸形愈合［J］.中华创伤骨科杂志，2017，19（9）：750-754.doi：10.3760/cma.j.issn.1671-7600.2017.09.004http://dx.doi.org/10.3760/cma.j.issn.1671-7600.2017.09.004.

李睿，王子明，杜全印，等.中国西南人踝关节X线片形态学参数的初步研究［J］.中国矫形外科杂志，2016，24（11）：1023-1028.doi：10.3977/j.issn.1005-8478.2016.11.14http://dx.doi.org/10.3977/j.issn.1005-8478.2016.11.14.

Stagni R，Leardini A，Ensini A，et al.Ankle morphometry evaluated using a new semi-automated technique based on X-ray pictures［J］.Clin Biomech （Bristol，Avon），2005，20（3）：307-311.doi：10.1016/j.clinbiomech.2004.11.009http://dx.doi.org/10.1016/j.clinbiomech.2004.11.009.

薛浩文，褚虹宇，左解鹏，等.基于CT的中国正常成人踝关节三维形态学分析及应用研究［J］.中国临床解剖学杂志，2021，39（5）：539-545.doi：10.13418/j.issn.1001-165x.2021.05.008http://dx.doi.org/10.13418/j.issn.1001-165x.2021.05.008.

马仲锋，冯国英，齐明.腓骨远端双钩锁定接骨板内固定治疗Danis-Weber A、B型外踝骨折［J］.中国骨与关节损伤杂志，2021，36（6）：579-582.doi：10.7531/j.issn.1672-9935.2021.06.005http://dx.doi.org/10.7531/j.issn.1672-9935.2021.06.005.

罗彪，余斌，金丹，等.下胫腓联合损伤的X线诊断研究［J］.中华创伤骨科杂志，2009，11（4）：342-345.doi：10.3760/cma.j.issn.1671-7600.2009.04.012http://dx.doi.org/10.3760/cma.j.issn.1671-7600.2009.04.012.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

暂无数据