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An oblique fibular tunnel is recommended when reconstructing the ATFL and CFL.

重建ATFL和CFL时,建议使用腓骨斜隧道。

  • 影响因子:3.28
  • DOI:10.1007/s00167-019-05583-3
  • 作者列表:"Michels F","Matricali G","Guillo S","Vanrietvelde F","Pottel H","Stockmans F
  • 发表时间:2020-01-01
Abstract

PURPOSE:A bone tunnel is often used during the reconstruction of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL). The purpose of this study is to compare proposed directions for drilling this fibular tunnel and to assess potential tunnel length, using a 5-mm-diameter tunnel and surrounding bone. METHODS:Anonymous DICOM data from spiral CT-scan images of the ankle were obtained from 12 Caucasian patients: 6 females and 6 males. Virtual tunnels were generated in a 3D bone model with angles of 30°, 45°, 60° and 90° in relation to the fibular long axis. Several measurements were performed: distance from entrance to perforation of opposing cortex, shortening of the tunnel, distance from tunnel centre to bone surface. RESULTS:A tunnel in a perpendicular direction resulted in an average possible tunnel length of 16.8 (± 2.7) mm in the female group and 20.3 (± 3.4) mm in the male group. A tunnel directed at 30° offered the longest length: 30.9 (± 2.5) mm in the female group and 34.4 (± 2.9) mm in the male group. The use of a 5-mm-diameter tunnel in a perpendicular direction caused important shortening of the tunnel at the entrance in some cases. The perpendicular tunnel was very near to the digital fossa while the most obliquely directed tunnels avoided this region. CONCLUSION:An oblique tunnel allows for a longer tunnel and avoids the region of the digital fossa, thereby retaining more surrounding bone. In addition, absolute values of tunnel length are given, which can be useful when considering the use of certain implants. We recommend drilling an oblique fibular tunnel when reconstructing the ATFL and CFL.

摘要

目的: 骨隧道常用于距腓前韧带 (ATFL) 和与腓韧带 (CFL) 的重建。本研究的目的是比较钻孔腓骨隧道的建议方向,并评估潜在的隧道长度,使用 5 毫米直径的隧道和周围的骨。 方法: 从 12 例高加索患者中获得踝关节螺旋ct扫描图像的匿名DICOM数据: 6 例女性和 6 例男性。在与腓骨长轴相关的角度为 30 ° 、 45 ° 、 60 ° 和 90 ° 的三维骨模型中生成虚拟隧道。进行了几次测量: 从入口到相对皮质穿孔的距离,隧道的缩短,隧道中心到骨表面的距离。 结果: 垂直方向的隧道导致女性组平均可能的隧道长度为 16.8 (± 2.7) mm,男性组为 20.3 (± 3.4) mm。以 30 ° 为导向的隧道提供最长长度: 女性组为 30.9 (± 2.5) mm,男性组为 34.4 (± 2.9) mm。在垂直方向上使用 5 毫米直径的隧道在某些情况下导致了入口隧道的重要缩短。垂直隧道非常靠近数字窝,而最倾斜的隧道避开了这个区域。 结论: 斜隧道允许更长的隧道,避免了指窝区域,从而保留了更多的周围骨。此外,给出了隧道长度的绝对值,当考虑使用某些植入物时,这可能是有用的。我们建议在重建ATFL和CFL时钻孔腓骨斜隧道。

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