成人小腿胫腓骨的应用解剖学观测

目的观测成人小腿胫、腓骨的相关形态学指标，为小腿骨折固定、自体骨移植提供解剖学依据，同时积累人体解剖学资料。方法利用游标卡尺、角规、求积仪，对52具成人出土骨骼（100侧）完整的小腿胫腓骨（左52侧、右48侧）进行形态学测量。结果成人胫骨长（35．7±1．77）cm、滋养孑L距内踝尖距离（23．8±1．46）cm、滋养孔时钟位左侧11时（5±0．25）分、右侧12时（1±0．22）分，腓切迹长（2．6±0．59）cm、宽（2．7±0．63）cm、深（0．6±0．22）cm，胫骨内踝关节面面积（2．5±1．56）cm2、下关节面面积（8．6±1．02）cm2；腓骨长（35．2±1．72）cm、滋养孔距外踝尖距离（19．3±2．04）cm、滋养孔时钟位左侧12时（2±0．21）分，右侧11时（58±0．17）分，腓骨头关节面面积（1．4±0．51）cm2，踝关节面面积（3．7±0．41）cm2，外踝沟长（2．6±0．59）cm、宽（2．7±0．63）cm、深（0．6±0．22）cm；内、外踝尖高度差（1．88±0．42）cm。结论胫腓骨骨折的固定方式、固定装置的选择，自体骨移植以及骨、关节的重建均应以两骨的形态学为依据方能达到良好的治疗效果。

Applied anatomy of tibia and fibula in adults

Objective To observe the morphological index related to the tibular and fibular in adults and to provide anatomy references to the fracture fixation and autologous bone graft. Methods The tibia and fibula of 52 adults （52 left sides and 48 right side） were measured morphologically. Results The length of the tibia was （ 35.7 ± 1.77） cm, the distance from the nutrient foremen to the point of interior ankle was （23.8 ± 1.46 ）cm, the length, width and depth of fibula notch were （2.6 ± 0.59 ）cm, （2.7 ± 0.63 ）cm and （0.6 ± 0. 22）cm respectively,the area of interior ankle articular surface in tibia was （2.5 ± 1.56） cm2 and the area of lower articular surface was （8.6 ± 1.02） cm2. The length of the fibula was （ 35.2 ± 1.72） cm,the distance from the nutrient foremen to exterior ankle point was （ 19.3 ± 2.04） cm, the length, width and depth of lateral malleolus sulcus were （2.6 ± 0.59 ） cm, （2.7 ± 0. 63 ） cm and （0.6 ± 0.22 ） cm respectively, the area of head of fibula articular surface was （ 1.4 ± 0.51 ） cm2 and the area of ankle articular surface was （ 3.7 ± 0.41 ） cm2. The difference in height between medial malleolus and lateral malleolus was （ 1.88 ± O. 42） cm. Conclusion Morphology of the tibia and fibula should be taken into consideration when selecting fixation method and set, grafting autologous bone and rebuilding the bone and joint.