RESUMEN
Objective To explore the anatomical morphology and characteristics of the sustentaculum tali based on CT three⁃dimensional reconstruction, so to provide anatomical support for the treatment of calcaneal fractures with screw implantation. Methods From March 2019 to March 2020, a total of 336 adult calcaneal CT three⁃dimensional reconstruction images from the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University were collected after exclusion of inclusion criteria. The CT three⁃dimensional reconstruction of calcaneus was classified according to the β, the prolate axial intersection between sustentaculum tali and calcaneus on the normal posterior. Reference points, β; AB, the distance from the inside of sustentaculum tali to the inside of posterior talar articular surface; AC, the distance from the inside of sustentaculum tali to the outside of posterior talar articular surface; AD, the distance from the inside of sustentaculum tali to lateral of calcaneal; AE, the distance from the inside of sustentaculum tali to medial process of calcaneal tuberosity; AF, the distance from the inside of sustentaculum tali to calcaneal tuberosity; AG, the distance from the inside of sustentaculum tali to lateral process of calcaneal tuberosity. The results were statistically analyzed according to type, sex and body side. Results Under the β, the sustentaculum tali was classified into three types: typeⅠ(β<70°, 68 cases, 20.24%), type Ⅱ(70°≤β<80°, 153 cases, 45.54%), type Ⅲ(80°≤β<90°, 115 cases, 34.23%). For the distance of β, AB, AF, there were statistical differences between type Ⅲ and other types (P<0.05). For the distance of AE, there were statistical differences between type Ⅲ and typeⅠ(P<0.05). Meanwhile, for the distance of AB, AC, AD, AE, AF, AG, there were statistical differences between male and female (P<0.05). For the distance of β, AB, there were statistical differences between right and left (P<0.05). Conclusion Under the β, the sustentaculum tali is classified into three types, with the typeⅡas the main type. When treating calcaneal fractures with internal fixation, direction of screw implant can choose between 70° to 80° as soon as possible. The morphology and classification of sustentaculum tali are of certain clinical implication to treat calcaneal fractures.
RESUMEN
Objective To measure the anatomical morphology of coracoclavicular ligament based on fresh cadavers, and to provide anatomical basis for anatomical reconstruction of coracoclavicular ligament. Methods A total of 52 the acromioclavicular joints (fresh body specimen) was dissected, and the anatomical characteristics of coracoclavicular ligament were observed by dissecting acromioclavicular joint specimens. The anatomic data of which the length of the conoid ligament (QR), the length of the trapezoid ligament (ST) ; the distance from the conoid ligament attachment on coracoid to coracoid tip (RV), the distance from the trapezoid ligament attachment on coracoid to coracoid tip (TV), the distance form conoid ligament attachment on the clavicular to acromioclavicular joint (QU), the distance form the trapezoid ligament attachment on the clavicular to acromioclavicular joint (SU), the distance from supraclavicular plane to subcoracoid plane (WX) were measured ; and the mean diameter of the trapezoid ligament attachment on the clavicular (ā), the mean diameter of the conoid ligament attachment on the clavicular(b¯), the mean diameter of the trapezoid ligament attachment on the coracoid (c¯), the mean diameter of the conoid ligament attachment on the coracoid (d¯) were calculation. The measurement result underwent statistical analysis. Results The minimum diameter of the trapezoid ligament attachment on the clavicular and coracoid on the left and right sides, respectively. There were no significant differences in those anatomical morphology of the coracoclavicular ligament (P>0.05). The anatomical morphology of the diameter of coracoclavicular ligament attachment on the male and female had no significant difference (P>0.05). The maximum length of the conoid ligament was (14.19±2. 43/15. 87±2. 99) mm on the left and right sides, respectively. The distance from the conoid ligament attachment on coracoid to coracoid tip was ( 36. 66 ± 4. 25/33. 61 ± 3. 45 ) mm on the left and right sides, respectively. The mean diameter of the conoid ligament attachment on the clavicular and coracoid was (11.95± 1.43/ 11.23± 1.12)mm and (9.20± 1.60/7.90±0.76) mm on the left and right sides, respectively. There were significant differences in those anatomical morphology of the coracoclavicular ligament(P 0.05). The anatomical morphology of the coracoclavicular ligament on the male and female had no significant difference (P>0.05). Conclusion The comprehensive measurement of anatomical morphology of coracoclavicular ligament can provide an anatomical basis for shoulder joint diseases related to coracoclavicular ligament injury. It will help surgical staff perform a complete anatomic reconstruction of coracoclavicular ligaments for the surgical treatment of dislocation of the acromioclavicular joint.