本文選題：內(nèi)窺鏡 + 踝管綜合征��； 參考：《吉林大學(xué)》2006年碩士論文

【摘要】：踝管綜合征,又稱跖管綜合征,是指脛神經(jīng)或其分支經(jīng)過脛骨內(nèi)踝后面屈肌支持帶(又稱分裂韌帶)下面的骨纖維管時(shí),受壓而引起的癥候群,本病在臨床上不易引起注意,經(jīng)常誤診。傳統(tǒng)的方法都是采取手術(shù)方法,操作復(fù)雜,最重要的是損傷很大,預(yù)后并發(fā)癥也較多。二十世紀(jì)后期隨著光學(xué)儀器的不斷產(chǎn)生和高科技手段的面世,內(nèi)窺鏡技術(shù)在臨床各領(lǐng)域已廣泛應(yīng)用,而在周圍神經(jīng)的診斷和治療方面的應(yīng)用尚屬起步階段。采取內(nèi)窺鏡手術(shù)治療腕管和肘管綜合征具有操作迅捷出血少,不用止血帶,術(shù)后早期即可功能聯(lián)系,尤其是雙側(cè)手術(shù)的患者,減少了術(shù)后生活上的不便和痛苦,可很快恢復(fù)日常生活活動(dòng)。目前國(guó)內(nèi)外的文獻(xiàn)還沒有報(bào)道利用內(nèi)窺鏡技術(shù)進(jìn)行踝管綜合征的診斷和治療,分析原因?yàn)轷坠懿煌蠊芎椭夤?管道呈“L”型,踝關(guān)節(jié)活動(dòng)范圍小,無法通過踝關(guān)節(jié)的趾屈使管道變直,管道內(nèi)結(jié)構(gòu)復(fù)雜,利用chow兩點(diǎn)法無法徹底松解脛神經(jīng)。所以根據(jù)踝管的解剖特點(diǎn)我們通過解剖學(xué)研究設(shè)計(jì)一種內(nèi)窺鏡松解踝管的手術(shù)入路:即三點(diǎn)(內(nèi)踝尖至跟腱止點(diǎn)內(nèi)側(cè)緣連線中垂線上4.5cm;內(nèi)踝尖至跟骨結(jié)節(jié)連線中點(diǎn);跟骨結(jié)節(jié)至第一跖趾關(guān)節(jié)內(nèi)側(cè)緣連線中點(diǎn))入路、分段松解,并在新鮮尸體上取得成功。這也是本課題的創(chuàng)新點(diǎn)。
[Abstract]:Ankle tunnel syndrome, also known as metatarsal canal syndrome, refers to the syndrome caused by compression of the tibial nerve or its branches under the osseous fibrous canal under the posterior flexor flexor band (also known as the splittal ligament) of the tibial medial ankle, which is not easily noticed clinically. Often misdiagnosed. The traditional methods are surgical methods, the operation is complex, the most important is that the injury is very large, the prognosis complications are also more. In the late 20th century, with the development of optical instruments and the advent of high-tech means, endoscopy has been widely used in clinical fields, but its application in the diagnosis and treatment of peripheral nerves is still in its infancy. Endoscopic treatment of carpal tunnel and cubital tunnel syndrome has the advantages of less rapid bleeding, no tourniquet, early postoperative functional contact, especially bilateral surgery, which reduces the inconvenience and pain in postoperative life. Can resume daily life activity quickly. At present, there is no report on the diagnosis and treatment of ankle tunnel syndrome by endoscope in domestic and foreign literature. The causes are different carpal tunnel and cubital tunnel of ankle tunnel, the canal is "L" type and the range of ankle joint motion is small. The tube can not be straightened through the toe flexion of ankle joint, and the structure of the pipe is complex. The tibial nerve can not be completely released by chow two-point method. Therefore, according to the anatomical characteristics of the ankle canal, we designed an operative approach to release the ankle canal by endoscope through anatomical research: three points (4.5cm above the vertical line between the medial ankle tip and the Achilles tendon insertion point, the midpoint between the medial ankle tip and the calcaneal tubercle line), and the middle point from the medial ankle tip to the calcaneal tubercle line. Calcaneal nodules to the medial margin of the first metatarsophalangeal joint) approach, segmental release, and success on fresh cadavers. This is also the innovation of this topic.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2006
【分類號(hào)】：R687.2;R322

【共引文獻(xiàn)】

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