«上一篇/Previous Article|本期目录/Table of Contents|下一篇/Next Article»

中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:

期数:

2026年01期

页码:

54-58

栏目:

足部骨折

出版日期:

2026-02-05

文章信息/Info

Title:

Anatomical study of calcaneal sustentaculum tali lateral wall projection and its application in fracture internal fixation surgery

作者:

曹鹏飞 何毅 张寅 徐训安 蒋淳 刘勇

215129 苏州高新区人民医院骨科

Author(s):

Cao Pengfei;  He Yi;  Zhang Yin;  Xu Xunan;  Jiang Chun;  Liu Yong.

Department of Orthopedics, Suzhou New District People’s Hospital, Suzhou 215129, China

关键词:

跟骨;  载距突;  解剖学;  投影;  内固定

Keywords:

Calcaneus;  Sustentaculum tali;  Anatomy;  Projection;  Internal fixation

DOI:

10.3877/cma.j.issn.2096-0263.2026.01.008

文献标志码:

A

摘要:

目的 通过系统解剖学研究，明确跟骨载距突在跟骨外侧壁的投影范围及其空间位置特征，为临床跟骨骨折内固定过程中螺钉的植入位置、方向及长度选择提供解剖学依据，从而提高手术操作的安全性与准确性。方法 选取2021年1月至2021年12月收集的30具成年国人尸体足部标本（共60足），采用CT三维重建与实体解剖测量相结合的方法，对载距突的形态学特征及其在跟骨外侧壁的投影位置进行测量分析。以Gissane角顶点及后关节面作为解剖参照点，建立坐标定位体系，测量投影区相关几何参数，并利用直径2.0 mm克氏针模拟螺钉植入路径，对其临床可行性进行验证。结果 载距突在跟骨外侧壁的平均投影距离为（34.37±2.61）mm，投影区平均长度为（20.25±1.80）mm，宽度为（10.19±1.10）mm；载距突前倾角及内翻角分别为（30.60±4.73）°和（25.29±6.38）°。实体解剖结果显示，载距突投影区整体呈近似矩形，其测量数据与CT测量结果一致性良好（P＜0.05）。螺钉植入模拟实验中，所有克氏针均顺利穿过载距突，未观察到血管神经结构损伤或关节面穿破情况。结论 跟骨载距突在跟骨外侧壁具有相对稳定的投影位置和几何特征。基于解剖标志建立的坐标参数体系可为临床跟骨骨折内固定手术中螺钉精准植入提供可靠参考，有助于降低手术风险，提升操作安全性。

Abstract:

Objective To determine the projection range and coordinate parameters of the calcaneal sustentaculum tali on the lateral wall of the calcaneus through anatomical study, providing precise parameters for screw insertion position, angle, and length in clinical calcaneal fracture internal fixation surgery to improve surgical accuracy and safety. Methods Sixty foot specimens from 30 adult Chinese cadavers collected from January 2021 to December 2021 were selected. A combination of CT three-dimensional reconstruction technology and physical anatomical measurement was used to determine the morphological parameters of the sustentaculum tali and its projection coordinates on the lateral wall of the calcaneus. A coordinate system was established using the Gissane angle apex and posterior joint surface as references, measuring the geometric parameters of the sustentaculum tali projection area, and verifying the clinical application value of the projection area through 2.0mm Kirschner wire simulation of screw insertion pathway. Results The mean projection distance of the sustentaculum tali was (34.37±2.61)mm, with a mean projection area length of (20.25±1.80)mm and mean width of (10.19±1.10)mm. The mean anterior inclination angle of the sustentaculum tali was (30.60±4.73)°, and the mean varus angle was (25.29±6.38)°. Physical measurements showed that the projection area of the sustentaculum tali was approximately rectangular, with coordinate parameters highly consistent with CT measurement results (P<0.05). Screw insertion experiments confirmed that screws inserted according to the projection area coordinate parameters could effectively penetrate the sustentaculum tali without causing vascular or neurological injuries. Conclusion The projection of the calcaneal sustentaculum tali on the lateral wall of the calcaneus has a relatively fixed anatomical position and geometric morphology. The established coordinate parameter system can provide reliable anatomical basis for clinical calcaneal fracture internal fixation surgery, helping to improve the accuracy and safety of screw insertion and reduce the risk of surgical complications.

备注/Memo

备注/Memo:

基金项目：苏州高新区人民医院科学创新基金项目（SGY2020B02）

常用功能

更新日期/Last Update: 2026-05-19