三角韧带解剖学、影像学及生物力学.ppt

1、三角韧带解剖学、影像学及生物力学The Anatomy, Radiology and biomechanics of Deltoid Ligament张 宁 医师山东大学足踝外科中心山东大学第二医院手足外科Tel: +86 15098950665； E-mail:三角韧带的解剖The Anatomy of deltoid ligament三角韧带分为两层 6束 ， 浅层 4束，深层 2束p 浅层 :胫舟韧带、胫 跳跃 韧带、胫跟韧带及胫距后韧带浅层Tibionavicular ligament, Tibiospring ligament, Tibiocalcaneal ligament, Su

2、perficialposterior tibiotalar ligament.p 深层 :胫距前韧带深层及胫距后韧带深层Deep anterior tibiotalar ligament, Deep posterior tibiotalar ligament.三角韧带的解剖The Anatomy of deltoid ligament三角韧带的解剖The Anatomy of deltoid ligamentA B C图 1. A.胎儿踝部冠状面（ Mallory三色法染色）， 1.内踝， 2.三角韧带深层， 3.三角韧带浅层， 4.胫后肌腱， 5.趾长屈肌腱， 6.载距突， 7.踇长屈肌腱，

3、 8.纤维鞘隔膜。 B.三角韧带浅层示意图， 1.胫舟韧带， 2.胫弹性韧带， 3.胫跟韧带， 4.胫距后韧带浅层， 5.跟舟上韧带（弹性韧带组成部分） 6.胫后肌腱， 7.跖侧跟舟韧带（弹性韧带组成部分） C.三角韧带深层， 1.胫距前韧带深层， 2.胫距后韧带深层。Fig. 1. Tibionavicular ligament. 2. Deep anterior tibiotalar ligament (deep layer). 3. Tibiospring ligament. 4. Tibiocalcaneal ligament. 5. Deep posterior tibiotalar

4、 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 inser

5、tion). 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三角韧带的解剖The Anatomy of de

6、ltoid ligamentFig. 3 Medial view of the anatomical dissection of the deep layer of the deltoid ligament. The superficial layer of the deltoid ligament has been resected. Its distal insertion is maintained (arrowheads). a Plantar flexion. b Dorsiflexion. 1. Deep anterior tibiotalar ligament. 2. Deep

7、posterior tibiotalar ligament. 3. Talar head. 4. Medial talar process. 5. Sustentaculum tali. 6. Anterior subtalar joint. 7. Posterior tibialtendon (cut at the level of insertion)三角韧带影像学（附着点）The Attachments of deltoid ligamentFigure 4. Representative lateral radiographic images of a right ankle demo

8、nstrating 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,

9、 tibionavicular ligament; TS, tibiospring ligament.三角韧带的附着点The Attachments of deltoid ligamentDATT, 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 MRIThe MRI of deltoid ligament