踝关节后侧稳定性损伤的相关解剖学及生物力学研究

Posterior malleolar fractures are commen injury, and always combine with ligaments injuries which might influence the ankle joint stability, and whether well understanding and pay enough attention will greatly influence the clinical outcomes. Clinical treatment and internal fixation in various ways, and lack of understanding of the injury mechanism as well as a unified point of view, and also have no special fixation material belong to the posterior malleolus. The aims of this project contains measurement of ankle posterior stability related bone - ligament structure parameter with use of anatomical and radiological methods; and evaluate different types of ankle joint posterior bone - ligament injuries on the effects of stability of ankle joint with use of biomechanical and finite element analysis methods. This project contains four aspects: 1) compare the effects of different operation methods on the stability of ankle joint and the joint pressure, when injury is caused by rotation violence; 2) compare the effects of different reduction degrees on the stability of ankle joint and joint pressure, when injury is caused by vertical force; 3) compare the reliability of different internal fixation methods and their effects on the stability of the ankle joint; 4) design a new posterior malleolus plate, and verify its biomechanical properties. We wish to elucidate the influence to the ankle joint stability of different posterior ankle bone - ligament injuries, and conclude scientifical and rational therapeutic strategies, and provide basic research evidences to clinical treatment of this type of injuries, and provide new fixation materials for internal fixation. And in order to improve the efficacy and long - term outcomes and save medical resources and costs basic of current results.

常见的踝关节损伤，多数伴有与踝关节稳定相关的后侧骨-韧带结构损伤，处理不当容易致残。目前对其损伤机制、科学治疗缺乏认识和研究。本项目旨在通过解剖及影像学研究测量与踝关节后侧稳定性相关的骨与韧带结构参数；通过生物力学和有限元实验，研究不同类型踝关节后侧骨－韧带损伤及不同固定方法对踝关节稳定性的影响：1、对旋转暴力所致后踝骨折合并下胫腓联合韧带损伤，比较研究不同手术方法对踝关节稳定性和关节压力分布的影响；2、对垂直暴力所致后踝骨折，比较研究不同复位程度对踝关节稳定性和关节压力分布的影响；3、比较研究不同内固定方式的可靠性和对踝关节稳定性恢复的影响；4、根据以上研究结果设计新型后踝钢板，并验证其生物力学特性和可靠性。通过以上实验阐明不同踝关节后侧骨-韧带结构损伤对踝关节稳定性的影响，探讨科学合理的治疗策略，对临床合理治疗此类损伤提供基础理论依据，并提供新型内固定材料。以达到提高临床近、远期疗效。

后踝骨折常伴有涉及踝关节稳定的韧带损伤，认识和重视不够常造成不良临床后果。目前临床治疗方案和内固定方式众多，但缺乏机制认识、统一观点及后踝骨折的特殊固定材料。本项目通过解剖及影像学研究测量踝关节后侧稳定性相关的骨－韧带结构参数；通过生物力学和有限元实验，研究不同损伤类型的踝关节后侧骨－韧带损伤对踝关节稳定性的影响：（1）比较旋转暴力所致后踝骨折及合并下胫腓联合韧带损伤不同手术方案对踝关节稳定性和关节压力分布的影响；（2）比较垂直暴力所致后踝骨折不同复位程度对踝关节稳定性和关节压力分布的影响；（3）比较不同内固定方式的可靠性和对踝关节稳定性恢复的影响。最终通过以上实验阐明踝关节后侧骨－韧带结构损伤对踝关节稳定性的影响，探讨科学合理的治疗策略，对临床合理治疗此类损伤提供基础理论依据。以达到提高临床近期和远期疗效，节约医疗资源。