三角韧带解剖学、影像学及生物力学.ppt

三角韧带解剖学、影像学及生物力学 TheAnatomy,RadiologyandbiomechanicsofDeltoidLigament ;三角韧带的解剖The Anatomy of deltoid ligament;三角韧带的解剖The Anatomy of deltoid ligament;三角韧带的解剖The Anatomy of deltoid ligament;Fig. 1. Tibionavicular ligament. 2. Deep anterior tibiotalar ligament (deep layer). 3. Tibiospring ligament. 4. Tibiocalcaneal ligament. 5. Deep posterior tibiotalar ligament (deep layer). 6. Superomedial calcaneonavicular ligament (component of spring ligament). 7. Plantar calcaneonavicular ligament (component of spring ligament). 8. Navicular tuberosity. 9. Medial talar process.10. Sustentaculum tali. 11. Posterior tibial tendon (cut at the level of the insertion). 12. Flexor hallucis longus (cut proximal and distal). 13.Tibialis anterior tendon (cut at the level of insertion). 14. Long plantar ligament. 15. Plantar calcaneocuboid ligament. 16. Calcaneal tendon (cut at the level of insertion) ;三角韧带的解剖The Anatomy of deltoid ligament;三角韧带影像学（附着点）The Attachments of deltoid ligament;Figure 4. Representative lateral radiographic images of a right ankle demonstrating the sites of attachment and courses of the individual bands of the (A) superficial and (B) deep deltoid: DATT, deep anterior tibiotalar ligament; DPTT, deep posterior tibiotalar ligament; SL, spring ligament; SPTT, superficial posterior tibiotalar ligament; TC, tibiocalcaneal ligament; TN, tibionavicular ligament; TS, tibiospring ligament.;三角韧带的附着点The Attachments of deltoid ligament;三角韧带的MRIThe MRI of deltoid ligament;三角韧带的MRIThe MRI of deltoid ligament;三角韧带的MRIThe MRI of deltoid ligament;三角韧带的MRIThe Attachments of deltoid ligament;三角韧带的MRIThe Attachments of deltoid ligament;三角韧带的功能The function of deltoid ligament; 三角韧带对踝关节的稳定作用越来越受到国内外学者的重视。Rasmussen等[6]发现三角韧带浅层主要限制距骨外移及外翻，三角韧带深层主要限制距骨的外旋。Ziai P等[7]通过体外生物力学研究发现在外侧副韧带损伤的情况下，三角韧带浅层阻止了踝关节继续外旋或外翻，而深层结构在稳定距下关节所起的作用较小，因此三角韧带浅层在踝关节外侧稳定中起到了重要的作用。Earll等[8]报道切断浅层三角韧带后，胫??关节接触面积下降43%，压力峰值增加30%，距骨外移4mm。复旦大学上海医学院马昕教授及其研究生根据尸体解剖结果提出胫舟韧带可能只是踝关节囊加强组织，三角韧带在踝关节屈伸运动过程中存