第3腓骨肌应用于韧带重建术的解剖学研究

目的　观察第3腓骨肌（the peroneus tertius，PT）的止点形态并测量相关数据，为PT用于韧带重建术提供解剖学基础。 方法　对34例离体踝关节标本进行测量，记录PT止点至肌腱交界处长度（D1）、止点至伸肌下支持带远端长度（D2）、止点附着处肌肉和肌腱宽度、厚度，并根据止点形态进行分类。 结果　PT止点形态分为4种类型，出现率分别为17.65%、35.29%、41.18%和5.88%。测得D2为（58.12±6.82）mm；D1为（68.22±6.76）mm；PT止点宽度为（32.59±10.61）mm；PT肌腱联合处宽度为（3.91±0.73）mm；PT厚度为（1.12±0.18）mm。PT各形态D2不完全相同，差异具有统计学意义（H＝15.645，P<0.05）。PT各形态D1不完全相同，差异具有统计学意义（H＝15.027，P<0.05）。PT各形态止点宽度不完全相同，差异具有统计学意义（H＝28.098，P<0.05）。PT各形态肌腱交界处宽度不完全相同，差异具有统计学意义（H＝7.919，P<0.05）。PT各形态厚度俱无统计学差异（H＝1.638，P>0.05）。 结论　Ⅲ型止点出现率最高，IV型出现率最低。长度、宽度与体侧、性别无明显差异，但与止点类型存在显著差异。本研究可为临床韧带重建术等手术提供解剖学基础。

Anatomical study on the application of peroneus tertius in ligament reconstruction

Objective　To observe and measure the stop-point morphologic features of the peroneus tertius (PT), and provide anatomic basis for ligament reconstruction.　Methods　The distance from the tendon junction to the PT insertion point (D1), the distance from the PT insertion point to the extensor subservient distal band (D2) were measured. The width and thickness of the insertion point and the attachment of the muscle tendon were recorded in 34 cases of the isolated ankle joint specimens and were classified according to the type of insertion point. Results According to the PT insertion point pattern, the occurrence rate of the different patterns were 17.65 %, 35.29 %, 41.18 % and 5.88 %, respectively. The distance from the PT insertion point to the extensor subservient distal band was (58.12±6.82) mm. The distance from the tendon junction to the PT insertion point was (68.22±6.76) mm. The width of PT insertion point was (32.59±10.61) mm. The width of the PT tendon joint was (3.91±0.73) mm. The PT thickness was (1.12±0.18) mm. The D2 and the some PT patterns were not completely same, and there was statistical significance among them (H = 15.645, P<0.05). The D1 and the some PT patterns were not completely same, and there was statistical significance between them (H = 15.027, P<0.05). The width of PT terminal point in each pattern was not completely same, and there were statistical significance between them (H = 28.098, P<0.05). The width of the junction of the tendons in each PT pattern was not completely same, and there were statistical significance between them (H = 7.919, P<0.05). There was no statistical difference in the thickness of PT (H = 1.638, P>0.05). Conclusions The occurrence rate of type Ⅲ stop-point is the highest, and that of type IV stop-point is the lowest. There were no significant differences in length, width, body side and gender, but there were significant differences in the type of stop-point, which is helpful for clinical ligament reconstruction and other operations.