内侧楔骨与第2跖骨底间韧带的解剖研究及临床意义

目的 测量内侧楔骨至第2跖骨底间韧带的相关参数，为临床治疗Lisfranc损伤提供解剖学依据。 方法 20例新鲜成人足部标本，解剖测量背侧韧带、Lisfranc韧带和跖侧韧带的长、宽，并观测Lisfranc韧带的走行方向和其在内侧楔骨的起点位置。 结果 背侧韧带长为（5.44±0.83）mm，宽为（4.20±0.64）mm；跖侧韧带长为（7.07±1.05）mm，宽为（5.23±1.10）mm；Lisfranc韧带长为（9.33±1.34）mm，宽为（8.00±1.23）mm，其与第2跖骨干中轴近端夹角为（61.45±5.03）°，其在内侧楔骨外侧面起点距关节面背侧（10.89±0.84）mm，跖侧（8.31±0.92）mm，远端（5.35±0.60）mm，近端（12.04±0.85）mm。 结论　Lisfranc韧带最为粗大，跖侧韧带次之，背侧韧带最为薄弱。内固定治疗Lisfranc损伤，可参照Lisfranc韧带起点位置和走行方向的解剖数据。

Ligaments between the first Cumeiform and the second metatarsal base: anatomy and clinical significance

Objective To explore anatomic features of the ligaments between the first cuneiform and the second metatarsal base,and provide basis for the treatment of Lisfranc injury.Methods 20 normal adult fresh foot specimens were dissected.The length and width of the ligaments between the first cuneiform and second metatarsal base,including dorsal ligament,plantar ligament and Lisfranc ligament,the included angle between Lisfranc ligament and the shaft of the second metatarsal bone,and the distance between the origin of Lisfranc ligament and the border of the first cuneiform,were measured and analyzed respectively.Results The lengths and widths of dorsal ligament,plantar ligament and Lisfranc ligament were(5.44±0.83)mm and(4.20±0.64)mm,(7.07±1.05)mm and(5.23±1.10)mm,(9.33±1.34)mm and(8.00±1.23)mm,respectively.The included angle between Lisfranc ligament and the shaft of the second metatarsal bone was(61.45±5.03)°.The distances from the origin of Lisfranc ligament to the dorsum of the first cuneiform,the planta of the first cuneiform,the distal and proximal end of the first cuneiform,were(10.89±0.84)mm,(8.31±0.92)mm,(5.35±0.60)mm,and(12.04±0.85)mm respectively.Conclusions Within the Lisfranc complex,the Lisfranc ligament is the largest one,the dorsal ligament is the smallest and the plantar ligament is in the middle among them.The origin site of Lisfranc ligament and the included angle between Lisfranc ligament and the shaft of the second metatarsal bone can provide reference for the treatment of Lisfranc injury.