内侧楔骨与第2跖骨底间韧带重建的解剖学研究

目的　通过对内侧楔骨与第2跖骨底间韧带进行形态学相关参数测量，为其重建提供解剖学依据。 方法　8只新鲜成年尸体足部标本，测量跗跖背侧及跖侧韧带、Lisfranc韧带的长、宽、面积，Lisfranc韧带附着点距关节面距离及其走行角度。根据测量数据，建立内侧楔骨-第2跖骨底间骨隧道。 结果　Lisfranc在3条韧带中形态学数据最大，长、宽、面积分别为(9.11~12.03 mm)、(7.36~10.16 mm)、（92.01~120.01 mm²)。骨隧道进针点在第2跖骨底，距第2跖骨-中间楔骨关节面距离为（8.25~11.22 mm），角度与Lisfranc韧带走行一致，与矢状面呈(39.2°~47.6°），水平面呈（12.5°~19.8°），出针点为Lisfranc韧带在内侧楔骨上的附着点。 结论　Lisfranc韧带在3条韧带中最为粗壮，重建通道应按照其附着点和走行角度重建背侧韧带和Lisfranc韧带，而跖侧韧带由于位置较深，受技术所限，此为类解剖重建。

Anatomic study on the reconstruction of ligaments between the first cuneiform and second metatarsal base

Objective　Morphological measurements of Lisfranc ligament complex were made to provide anatomical basis for ligament reconstruction.　Methods　8 fresh adult cadaver foot specimens were dissected. The length, width and area of the ligaments between the medial cuneiform(C1) and second metatarsal base (M2), including dorsal ligament, plantar ligament and Lisfranc ligament, the distance from the articular surface of Lisfranc ligament, and the angle of Lisfranc ligament were measured and analyzed， respectively. According to the measurement results, bone tunnel between the first cuneiform and second metatarsal base was established.　Results　Lisfranc ligament was the largest among the three ligaments, The lengths,widths and area were (9.11~12.03 mm), (7.36~10.16 mm), (92.01~120.01 mm²)，respectively. Lisfranc bone tunnel: the entry point was (8.25~11.22 mm) from C2-M2 joint; the angle was consistent with the Lisfranc ligament course, which was (39.2°~47.6°) degrees to the sagittal plane and (12.5°~19.8°) degrees to horizontal plane; the exit point was Lisfranc ligament origin of the first cuneiform. Conclusion Lisfranc is the most robust among the three ligaments. The bone tunnel of reconstruction is established for the formation of Lisfranc ligament and dorsal ligament in accordance with Lisfranc ligament angle and attachment. Since the position of plantar ligament is deep, the reconstruction is close to approximate anatomical reconstruction due to the technical limitations.