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目的对外踝及其周围结构进行解剖学观测,为外踝骨折内固定及设计外踝定位导向器提供解剖学基础。方法 180例(男20对,女20对)干燥腓骨下端形态进行观察分析;240例(男20,女20)X线片观察外踝的大体形态;340具(男20,女20)尸体解剖观测外踝前动脉、腓浅神经,腓肠神经毗邻关系。结果 (1)外踝从上往下骨质逐渐均匀的变薄变窄,近似一个倒立的三角形;(2)骨性标本外踝左右两侧高度、宽度、厚度测量比较差异无统计学意义(P>0.05);但存在性别差异(P<0.05)。(3)男女X线片上外踝角测量比较差异无统计学意义(P>0.05);(4)外踝前动脉在距离外踝尖端平面男性(4.30±0.22)cm,女性(4.11±0.6)cm处由胫前动脉发出,先斜向外下方至腓骨下端;然后紧贴腓骨下端及外踝前缘进入足背。(5)腓浅神经主干距离外踝前缘男性(1.59±0.20)cm,女性(1.31±0.64)cm;腓肠神经经过外踝后外下方,距离外踝后缘男性(1.80±0.13)cm,女性(1.62±0.34)cm;结论外踝及其周围结构的解剖学测量结果为外踝骨折内固定以及设计外踝定位导向器提供解剖学基础。
Objective To anatomize the lateral malleolus and its surrounding structures and provide anatomical basis for the internal fixation of the lateral malleolus and the design of the lateral malleolus positioning guide. Methods 180 cases (20 males and 20 females) of the lower fibula were observed and analyzed. The gross appearance of lateral malleolus was observed in 240 cases (20 males and 20 females). The autopsy results of 340 males (20 males and 20 females) Anterolateral ankle artery, peroneal nerve, sural nerve adjacent relationship. Results (1) The lateral malleolus became thinner and thinner gradually from top to bottom, almost an inverted triangle. (2) There was no significant difference in height, width and thickness between the lateral malleolus and the lateral malleolus (P> 0.05), but there was gender difference (P <0.05). (3) There was no significant difference in the lateral malleolus angle between the male and the female X-ray films (P> 0.05). (4) The anterior lateral malleolus was located at the level of 4.30 ± 0.22 cm and 4.11 ± 0.6 cm Anterior tibial artery issued, the first oblique outward below the lower end of the fibula; and then close to the lower edge of the fibula and the lateral margin of the ankle into the dorsal foot. (5) The trunk of the superficial peroneal nerve was (1.59 ± 0.20) cm and 1.31 ± 0.64 cm from the anterior edge of the lateral malleolus. The sural nerve passed posterior lateral malleolus (1.80 ± 0.13) cm, 1.62 ± 0.34) cm. Conclusion The anatomical findings of the lateral malleolus and its surrounding structures provide an anatomic basis for the internal fixation of the lateral malleolus fracture and the design of the lateral malleolus positioning guide.