CAJ | 학술논문

目的：应用 CT 三维重建为载距突体表定位，并测量跟骨外侧壁指定点向载距突置钉角度及螺钉长度，为跟骨手术提供理论依据。方法选用30个成人足踝部湿性标本，使用螺旋 CT 扫描并三维重建，观察测量找到载距突体表定位的新方法；CT 扫描40只成人跟骨干性标本，利用软件分别测量载距突中点与跟骨外侧壁指定点之间的线段的角度和长度。结果在踝关节功能位下，以足内侧面定为“矢状参考面”测量，内踝前缘与载距突前缘在同一冠状面上，经内踝前缘的垂线与过载距突前缘冠状线相交于一点，该点与内踝前缘的垂直距离为（34．95±2．60）mm ，载距突长度为（21．44±1．89）mm ，高度为（10．17±1．16）mm ，载距突前倾角为（35．31±3．73）°。自跟骨外侧壁找到6个具有代表性的测量点，其与载距突连线测量结果如下：在跟骨前部，G 、E 两点上倾角分别为（28．78±3．90）°、（29．47±2．96）°，前倾角分别为（－19．83±4．60）°（－11．02±4．74）°；在后关节面下方，C 、K 、I 、J 4点上倾角为（2．52±2．46）°、（2．92±2．28）°、（14．98±2．49）°、（14．38±1．90）°，前倾角分别为（7．32±1．66）°、（19．25±1．98）°、（10．30±2．63）°、（19．33±1．97）°。置入螺钉的长度在40～44 mm ，C 点最小，G 点最大。结论在踝关节功能位下以内踝前缘做标志，可以在体表定位载距突；利用 CT 及工作站软件可以准确测量自跟骨外侧壁各点到载距突的角度和长度。
목적：응용 CT 삼유중건위재거돌체표정위，병측량근골외측벽지정점향재거돌치정각도급라정장도，위근골수술제공이론의거。방법선용30개성인족과부습성표본，사용라선 CT 소묘병삼유중건，관찰측량조도재거돌체표정위적신방법；CT 소묘40지성인근골간성표본，이용연건분별측량재거돌중점여근골외측벽지정점지간적선단적각도화장도。결과재과관절공능위하，이족내측면정위“시상삼고면”측량，내과전연여재거돌전연재동일관상면상，경내과전연적수선여과재거돌전연관상선상교우일점，해점여내과전연적수직거리위（34．95±2．60）mm ，재거돌장도위（21．44±1．89）mm ，고도위（10．17±1．16）mm ，재거돌전경각위（35．31±3．73）°。자근골외측벽조도6개구유대표성적측량점，기여재거돌련선측량결과여하：재근골전부，G 、E 량점상경각분별위（28．78±3．90）°、（29．47±2．96）°，전경각분별위（－19．83±4．60）°（－11．02±4．74）°；재후관절면하방，C 、K 、I 、J 4점상경각위（2．52±2．46）°、（2．92±2．28）°、（14．98±2．49）°、（14．38±1．90）°，전경각분별위（7．32±1．66）°、（19．25±1．98）°、（10．30±2．63）°、（19．33±1．97）°。치입라정적장도재40～44 mm ，C 점최소，G 점최대。결론재과관절공능위하이내과전연주표지，가이재체표정위재거돌；이용 CT 급공작참연건가이준학측량자근골외측벽각점도재거돌적각도화장도。
Objective To use CT and 3D reconstruction technique to locating mark of sustentaculum tali ,and measure the an‐gle & length of the specified point of the lateral wall of the calcaneus to sustentaculum tali for providing .To basis for the operation of calcaneus .Methods Thirty adult ankle wet specimens were chosen and scanned with CT ,and the dicom data were converted into the software to 3D‐reconstruction ,the observation and measurement to find new methods of locating mark of sustentaculum tali ;Forty adult calcaneus dried specimens were chosen and scanned with CT .The dicom data were converted into the software to 3D‐re‐construction ,using a workstation software measure the angle and length of the line which from the center of the sustentaculum tail to each point on the calcaneal lateral wall .Results First ,in the function of ankle joint position ,with the foot medial surface as “sag‐ittal reference plane” measurement ,the vertical line passing through the leading edge of medial malleols and the coronal line passing through the leading edge of sustentaculum tali intersect at a point .The vertical distance of the point to leading edge of medial malle‐ols was (34 .95 ± 2 .60) mm ,the length of sustentaculum tali was (21 .44 ± 1 .89) mm ,the height of sustentaculum tali was (10 .17 ± 1 .16) mm ,the anteversion of sustentaculum tali was (35 .31 ± 3 .73)° .Second ,in front of calcaneus ,upward angel of points G ,E were (28 .78 ± 3 .90 )° ,(29 .47 ± 2 .96 )° respectively .Frontward angle of points G ,E were ( - 19 .83 ± 4 .60 )° , ( - 11 .02 ± 4 .74)° respectively .Under the posterior articular surface ,upward angel of points C ,K ,I ,J were(2 .52 ± 2 .46)° ,(2 .92 ± 2 .28)° ,(14 .98 ± 2 .49)° ,(14 .38 ± 1 .90)° respectively .Frontward angle of points C ,K ,I ,J were(7 .32 ± 1 .66)° ,(19 .25 ± 1 .98)° , (10 .30 ± 2 .63)° ,(19 .33 ± 1 .97)° respectively .The length of screw was about 40 - 44 mm .The length of C point to the sustentacu‐lum tail was minimum ,and the length of G was maximum .Conclusion In the function of ankle joint position ,the sustentaculum tail can be located with the leading edge of medial malleols as a surface landmarks .The measurement of the angle and length of which from each point on the calcaneal lateral wall to sustentaculum tail by using CT .