踝骨

Fig. 1-34 Osteotomy of medial malleolus for osteochondritis dissecans of talus.

图1-34 用于距骨剥脱性骨软骨炎的内踝截骨术。

Curve the incision just proximal to the medial malleolus (Fig. 1-33, A) and divide the malleolus with an osteotome or small power saw; preserve the attachment of the deltoid ligament.

于内踝稍近侧做弧形切口(图1-33A)，用骨凿或小的动力锯截断内踝，保留三角韧带的附着点。

Cure the incision just proximal to the medial malleolus (Fig. 1-33, A) and diide the malleolus with an osteotome or small power saw; presere the attachment of the deltoid ligament.

于内踝稍近侧做弧形切口(图1-33A)，用骨凿或小的动力锯截断内踝，保留三角韧带的附着点。

The constant nutritional arteries of the great saphenous vein-saphenous nerve on the medial foot: Perforator at medial side of the tendon of the tibialis anterior ,it is （2.27±0.43）cm distal to the intermalleolar line .it passes across the medial side of the tendon of the tibialis anterior and pierces the deep fascia between the upper and lower bundle of the inferior extensor retinaculum with a diameter of （0.72±0.04）mm;The length of it after piercing the deep fascia is （7.3±0.6）mm,It has an emerging rate of 95%; Perforator between tendons ,it is （3.02±0.39）cm distal to the intermalleolar line;it pierces the deep fascia between the tendons of tibialis anterior and extensor digitorum longus with a diameter of (0.57±0.06)mm ;The length of it after piercing the deep fascia is （7.4±0.6）mm .It has an emerging rate of 94%; A constant distal fascial perforator pierces the deep fascia between abductor hallucis muscle and medial side of first metatarsal bone （1.97±0.23）mm distal to the first metatarsophalangeal joint with a diameter of (0.50±0.03)mm.

足内侧大隐静脉-隐神经营养血管近端来自内踝前动脉较为恒定，外径较大的穿支有：踝间线远端（2.27±0.43）cm，经胫骨前肌腱内侧、伸肌下支持带上、下束间穿出，外径(0.72±0.04)mm ，穿出深筋膜的长度为（7.3±0.6）mm，出现率为95%；踝间线远端（3.02±0.39）cm，经胫骨前肌腱与趾伸肌腱穿出，外径(0.57±0.06)mm，穿出深筋膜的长度为（7.4±1.2）mm ，出现率为94%；3远端来自交通支最为恒定，外径较大的穿支于踇展肌与第一跖骨内侧缘之间穿出深筋膜，距第一跖趾并节近端（1.97±0.23）cm，直径（0.50±0.03）mm，穿出深筋膜的长度为（6.5±0.5）mm，出现率为100%。

Methods: 42 shadowgraphs of patients with trimalleolar fractures were studied, and an independent classification of trimalleolar fractures is concluded according to the dislocation of their talus.

根据42例三踝骨折脱位病人的原始 X 线片，对其距骨移位的规律进行研究总结，并据此探讨三踝骨折的独立分型。

Large cancellous and corticocancellous grafts may be obtained from the anterosuperior iliac crest and the posterior iliac crest. Small cancellous grafts may be obtained from the greater trochanter of the femur, femoral condyle, proximal tibial metaphysis, medial malleolus of the tibia, olecranon, and distal radius. At least 2 cm of subchondral bone must remain to aoid collapse of the articular surface.

大块的松质骨或皮质-松质骨复合植骨块，可取自髂前上棘或髂后棘，小块松质骨块可以取自股骨大粗隆、股骨髁、胫骨近侧干骺端、内踝、尺骨鹰嘴及桡骨远端，但至少要保留2cm的软骨下骨以防止关节面的塌陷。

Large cancellous and corticocancellous grafts may be obtained from the anterosuperior iliac crest and the posterior iliac crest. Small cancellous grafts may be obtained from the greater trochanter of the femur, femoral condyle, proximal tibial metaphysis, medial malleolus of the tibia, olecranon, and distal radius. At least 2 cm of subchondral bone must remain to avoid collapse of the articular surface.

大块的松质骨或皮质-松质骨复合植骨块，可取自髂前上棘或髂后棘，小块松质骨块可以取自股骨大粗隆、股骨髁、胫骨近侧干骺端、内踝、尺骨鹰嘴及桡骨远端，但至少要保留2cm的软骨下骨以防止关节面的塌陷。

METHODS: From April 1996 to March 2001, 9 talar neck fractures were treated by internal fixation of absorbable lag screw with a medial approach and cut of medial malleolus to expose the fractures.

1996年 4月～ 2 0 0 1年 3月，采用足内侧途径加内踝截骨显露距骨颈骨折，利用可吸收螺钉对骨折行内固定治疗 9例移位的距骨颈骨折。

METHODS: We performed autologous chondrocyte transplantation in twelve patients with a focal deep cartilage lesion of the talus. There were seven female and five male patients with a mean age of 29.7 years. The mean size of the lesion was 2.3 cm(2). All patients were studied prospectively. Evaluation was performed with use of the Hannover ankle rating score, the American Orthopaedic Foot and Ankle Society ankle-hindfoot score, a visual analog scale for pain, and magnetic resonance imaging.

我们对12例距骨软骨缺损的患者采用自体软骨细胞移植术，7名男性和5名女性，平均年龄29.7岁，缺损的平均大小是2.3平方厘米，所有的患者进行前瞻性研究，利用Hannover踝关节等级评分和美国矫形外科学会足踝分会踝后足评分进行评估，对疼痛和磁共振影像学进行直观类比标度。

Methods 6 sets of data were measured on the 166 radiograms of normal ankle joint. There were length of lateral malleolus (L1), length of tibiofibular overlapping (L2), adds of L1 and L2, three angles of difference point of medial malleolus.

测量166例正常成人踝穴位X线片上外踝长度(L1)、下胫腓重叠影的长度(L2)以及两者之和(L3)和内踝远端内下骨皮质表面不同的3点在胫骨远端骨质范围内投影的夹角，分析其相互间特点。

As she looked at Warrington's manly face, and dark, melancholy eyes, she had settled in her mind that he must have been the victim of an unhappy attachment.

每逢看到沃林顿那刚毅的脸，那乌黑、忧郁的眼睛，她便会相信，他一定作过不幸的爱情的受害者。

Maybe they'll disappear into a pothole.

也许他们将在壶穴里消失