摘要
目的:对腓深神经的走形进行解剖观察,为微创钢板固定法(MIPO)技术治疗胫骨近端骨折避免损伤腓深神经提供解剖学基础。方法:取12具成人尸体24例膝关节标本,模拟MIPO技术治疗胫骨近端骨折手术入路,解剖周围重要的神经血管及其分支进行细致的观察和测量。结果:腓深神经由腓总神经发出后与胫前动脉伴行,在小腿上1/3段位于胫骨前肌和趾长伸肌之间,下2/3段位则于胫骨前肌和踇长伸肌之间。其中以胫骨粗隆最高点和腓骨头连线为底线,向下约(35±2.1)°在离胫骨粗隆(51.6±2.8)mm处腓总神经有一较大分支(胫前关节返支)垂直胫骨方向进入胫骨前肌,分布于膝关节周围。在离胫骨粗隆5,10,15cm处分别测得腓深神经到胫骨前缘的距离分别为(36.8±2.5)mm,(30.1±1.9)mm,(27.0±1.2)mm。结论:胫骨外侧存在一个倒三角形的安全区域,在此区域内行MIPO技术治疗胫骨近端骨折安全可行。
Objective=To study the anatomic features of the common peroneal nerve and provide more de- tailed anatomic data for avoiding injure it when use the MIPO technology to treat proximal tibial fractures. Twelve adult cadaverie knee joints were taken. Simulated the minimally invasive plating for lateral tibial plateau fractures, then dissected the important nerves and blood vessels and its branches around the plate, careful observation and measurement these structures. Results= The deep peroneal nerve was issued by the peroneal nerve and along with anterior tibial artery, first 1/3 of which was between tibialis anterior muscle and extensor digitorum longus and the rest was betweeen tibialis anterior muscle and hallux longus muscle in the calf. The line between the highest point of the tuberosity of tibia and the fibular head as the bottom line, down to about （35±2.1）°, away from the highest point of the tuberosity of tibia （51.6±2.8） mm, there was a branch of common peroneal nerve （anterior tibial recurrent branch） go into thetibialis anterior muscle. Down to the highest point of the tuberosity of tibia 5, 10 and 15 mm, the distances from the tibial ridge to the deep peroneal nerve, anterior tibial artery and veins was （36.8±2.5）, （30.1±1.9） and （27.0±1.2） ram; respectively. Conclusion：There is an inverted triangle security zone in the lateral tibial. It is safe when we do the operation of minimally invasive plating for lateral tibial plateau fractures in this zone.
出处
《广西医科大学学报》
CAS
2013年第3期341-343,共3页
Journal of Guangxi Medical University
基金
广西卫生厅重点课题资助项目(No.200833)
关键词
应用解剖
MIPO
胫骨近端骨折
applied anatomy
minimal invasive plate osteosynthesis
tibial plateau fractures
