摘要
目的:探讨腓总神经在胫骨近端的解剖学结构和手术安全区范围。方法:取20具尸体膝关节标本,显露股骨外侧髁、腓骨近端和胫骨外侧结节(Gerdy's结节)后,自股骨外侧髁后方向远端分离腓总神经及分支至其进入小腿前、外侧肌群处。测量腓总神经及分支至Gerdy’s结节之间的距离及相关角度。结果:Gerdy's结节最高点至腓总神经与腓骨头后方交点处的距离、至腓浅神经起始部的距离和至腓总神经前返支临近胫骨处的距离分别是(45.0±1.5)mm、(45.3±2.0)mm和(45.0±1.5)mm。Gerdy's结节最高点至腓总神经与腓骨头后方交点连线与Gerdy's结节最高点至腓浅神经起始部连线之间的夹角为33°±2.1°,与Gerdy's结节最高点至腓总神经前返支临近胫骨处连线之间的夹角为97°±2.3°。腓总神经及分支被限定在以Gerdy’s结节为中心,半径为45mm、弧度为97°的圆弧区域内。结论:利用Gerdy’s结节为标志,能容易地限定出腓总神经及分支在胫骨近端的走行轨迹,即手术安全区。于手术前标出安全区可避免对神经的损伤。
Objective： To explore the anatomical structures of the common peroneal nerve and the surgical safe zone at the level of the proximal tibia. Methods： Twenty adult cadaveric knee joints were dissected. After observing the lateral femoral condyle, the proxial fibula and Gerdy＇s tubercle, the common peroneal nerve was identified at the level of the posterior aspect of the lateral femoral condyle and was dissected distally to the level of its intramuscular branches. The relationship between the common peroneal nerve and Gerdy＇s tubercle was explored, the distances and the angles related from the nerve and its branches to the tubercle were measured and recorded. Results： The distance from the most prominent aspect of the Gerdy＇s tubercle to the common peroneal nerve behind the head of the fibula, the starting point of the superficial branch of the common peroneal nerve, the anterior recurrent brance of the common peroneal nerve was（45.0±1.5 ）mm,（45.3±2.0 ）mm and （45.0±1.5） mm respectively. The angle between the line of the most prominent aspect of the Gerdy＇s tubercle to the common peroneal nerve behind the head of the fibula and the line of the Gerdy＇s tubercle to the starting point of the superficial branch of the common peroneal nerve was about 33°±2.1°. The angle between the line of the most prominent aspect of the Gerdy＇s tubercle to the common peroneal nerve behind the head of the fibula and the line of the most prominent aspect of the Gerdy＇s tubercle to the anterior recurrent branch of the common peroneal nerve was about 97°±2.3°. The course of the common peroneal nerve trunk and its anterior recurrent branch was defined to an arc with the average radius of 45mm and the radian of 97°. This circumferential trajectory was seen to be centered at the Gerdy＇s tubercle. Conclusions： With Gerdy＇s tubercle used as a landmark, the trajectory of the peroneal nerve can be easily defined at the level of the proximal aspect of the tibia and marked prior to the operation, thereby avoiding damage to the peroneal nerve and its branches.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2006年第2期139-141,共3页
Chinese Journal of Clinical Anatomy
关键词
应用解剖
腓总神经
胫骨
手术安全区
applied anatomy
common peroneal nerve
tibia
surgical safe zone
