Objective To observe and measure the anatomical similarity of joint surface between the proximal fibular after os-teotomy and the original lateral ankle,and to investigate the feasibility and potential value of the clinical application of this tech-nique by simulating a wedge-shaped osteotomy of the proximal fibula and adjusting the direction of articular surface by using computer.Methods The data of the lower limbs CT of 40 adults in PLA Rocket Force Characteristic Medical Center were col-lected,and the fibula model was constructed using Mimics and 3-matic.The anatomical data such as the length,width,area,in-clination angle,and longest slope diameter of the distal and proximal articular surface of the fibula were measured,and the dif-ferences were analyzed to determine the wedge osteotomy plan of the proximal fibula,and then the osteotomy and lateral malleo-lus reconstruction process were simulated by computer.After fitting of the proximal articular surface of fibula and the external ankle joint surface was satisfactory,the inclination angle and longest slope diameter of the proximal fibula articular surface after osteotomy were measured and statistically analyzed.Results In the three-dimensional model of the fibula,the difference be-tween the transverse diameter of the proximal and distal articular surfaces of the fibula was not statistically significant(P＞0.05),and the longitudinal diameter,area,angle of inclination,and longest slope diameter of the distal articular surface of the fibula were greater than those of the proximal articular surface,and the difference was statistically significant(P＜0.05).The difference in the area between the proximal and distal articular surfaces was(107.67±55.55)mm2,with an ratio of(63.87±17.50)％.The dif-ference in the angle of inclination was(34.69±6.28)°,with an inclination angle ratio of(50.92±8.16)％.The difference in the lon-gest slope diameter was(4.30±2.76)mm,with the ratio was(84.11±9.56)％.After osteotomy,the angle of inclination of the proxi-mal articular surface was(69.10±4.53)°,compared with the distal articular surface of the fibula(70.65±5.14)°,there was no sig-nificant difference(P＞0.05).The longest slope diameter of the articular surface of the proximal fibula after osteotomy was(27.63±2.33)mm,while the longest slope diameter of the articular surface of the distal fibula was(26.78±2.29)mm,and the dif-ference was not statistically significant(P＞0.05).Conclusion It is feasible to reconstruct the external ankle using fibula head transplantation with an articular surface.By simulating the wedge osteotomy of the proximal fibula with computer software,the po-sition of the osteotomy line can be determined,the direction of the articular surface of the proximal fibula can be corrected,and the bony eminence near the articular surface of the proximal fibula can be eliminated,which is more conducive to the reconstruc-tion of the talofibular joint with the proximal fibula transplantation and helpful for the anatomic reconstruction.
External malleolus reconstructionFibula head transplantation with articular surfaceProximal fibular wedge osteot-omyTalofibular joint articular surface matching
万方数据
维普
