CAJ | 학술논문

目的探讨下胫腓联合相对运动，认识下胫腓联合运动特点。方法选用6例新鲜尸体标本，膝上10～15 cm截肢，去除皮肤、肌肉，制作骨-韧带标本，保留上、下胫腓关节周围韧带及踝关节韧带。将标本分别固定于踝关节背屈10°位、中立位、跖屈15°位，用电子万能实验机对标本进行600 N轴向加载，并在踝关节中立位时施加600 N轴向加载联合5 Nm外旋扭转加载，测量下胫腓联合远端腓骨相对远端胫骨内外位移、前后位移及远端腓骨绕轴旋转角度。结果600 N轴向加载情况下，踝关节由中立位变为跖屈15°位时远端腓骨相对远端胫骨有向内、向前位移，同时绕轴内旋；当踝关节由中立位变为背屈10°位时，远端腓骨相对远端胫骨有向外、向后位移，同时绕轴外旋。与单一轴向加载相比，联合加载下远端腓骨有向内、向后移位和外旋的运动趋势。结论下胫腓联合为微动关节，远端腓骨相对运动与踝关节体位及受力方式有关。
목적탐토하경비연합상대운동，인식하경비연합운동특점。방법선용6례신선시체표본，슬상10～15 cm절지，거제피부、기육，제작골-인대표본，보류상、하경비관절주위인대급과관절인대。장표본분별고정우과관절배굴10°위、중립위、척굴15°위，용전자만능실험궤대표본진행600 N축향가재，병재과관절중립위시시가600 N축향가재연합5 Nm외선뉴전가재，측량하경비연합원단비골상대원단경골내외위이、전후위이급원단비골요축선전각도。결과600 N축향가재정황하，과관절유중립위변위척굴15°위시원단비골상대원단경골유향내、향전위이，동시요축내선；당과관절유중립위변위배굴10°위시，원단비골상대원단경골유향외、향후위이，동시요축외선。여단일축향가재상비，연합가재하원단비골유향내、향후이위화외선적운동추세。결론하경비연합위미동관절，원단비골상대운동여과관절체위급수력방식유관。
Objective To explore relative motion of the syndesmosis and recognize the characteristics of the syndesmotic motion.Methods Six cadaveric specimens were tested in this study.The specimens were amputated 10 to 15 cm above the knee joint.The skin and muscles were removed.All ligaments around the syndesmosis,knee joint, and ankle joint were intact.The specimens were applied an axial load of 600 N when the ankle joint in the position of 10°dorsal flexion,neutral position,and 15°plantar flexion.When the ankle joint positioned neutrally,a combination of 600 N axial loading and 5 Nm externally rotational loading was applied to the specimens.The medial-lateral displacement,anterior-posterior displacement,and rotation of the distal fibula relative to the distal tibia were measured.Results Under the axial loading,the distal fibula tended to move medially and anteriorly,and rotate internally when the ankle moved from neutral position to 15°plantar flexed position.While when the ankle moved from neutral position to 10°dorsal flexed position,the distal fibula tended to move laterally and posteriorly,and rotate externally.Under the combined loading,with respect to the isolated axial loading,the distal fibula tended to move medially and posteriorly,and rotate externally relative to the distal tibia.Conclusion Micro-motion existed in the syndesmosis.The relative motion of the syndesmosis was correlated to the ankle position and loading patterns.