發(fā)布時(shí)間：2018-10-18 12:52

【摘要】：目的：評估改進(jìn)的踝關(guān)節(jié)后方“共軸入路”的安全性和可操作性。類型：解剖研究和臨床應(yīng)用。方法：20具防腐冷凍踝關(guān)節(jié)標(biāo)本平分為兩組；用克氏針在其中一組建立文獻(xiàn)報(bào)道的“共軸入路”、傳統(tǒng)后方入路和改進(jìn)的踝關(guān)節(jié)后方“共軸入路”；另一組分別在距離外踝尖端近側(cè)1.5cm高度水平2.5cm建立改進(jìn)的“共軸入路”。測量克氏針與踝關(guān)節(jié)后室重要解剖結(jié)構(gòu)的距離。使用2.7mm，，30°關(guān)節(jié)鏡在5具新鮮標(biāo)本上模擬實(shí)際手術(shù)建立改進(jìn)的踝關(guān)節(jié)后方“共軸入路”。臨床應(yīng)用于3例病例(4個(gè)踝關(guān)節(jié))。結(jié)果：改進(jìn)的“共軸入路”與小隱靜脈、足拇長屈肌腱和脛神經(jīng)的距離分別是22.07mm、5.39mm和6.27mm；原“共軸入路”與小隱靜脈、足拇長屈肌腱和脛神經(jīng)的距離分別是8.54mm、3.62mm和4.40mm。不同高度的“共軸入路”的靜態(tài)安全性接近。測量數(shù)值經(jīng)統(tǒng)計(jì)學(xué)分析得出：改進(jìn)的踝關(guān)節(jié)后方“共軸入路”同其它后方入路相比，器械距離踝關(guān)節(jié)后方重要解剖結(jié)構(gòu)是最大的。通過模擬手術(shù)過程，確定足拇長屈肌腱和足趾長屈肌腱為踝關(guān)節(jié)鏡操作的安全性“內(nèi)標(biāo)志”。無神經(jīng)血管的穿破和觸碰。臨床病例平均5個(gè)月隨訪未見并發(fā)癥。結(jié)論：與原“共軸入路”相比，改進(jìn)后的踝關(guān)節(jié)后方“共軸入路”具有安全性更高、操作更簡單和易重復(fù)的優(yōu)勢。
[Abstract]:Objective: to evaluate the safety and maneuverability of the modified posterior ankle coaxial approach. Type: anatomical study and clinical application. Methods: 20 antiseptic frozen ankle joint specimens were divided into two groups: "coaxial approach", traditional posterior approach and modified posterior "coaxial approach" with Kirschner needle. In another group, the improved "coaxial approach" was established at the height of 1.5cm at the proximal lateral malleolus. The distance between Kirschner's needle and the important anatomical structure of the posterior chamber of ankle joint was measured. The modified posterior "coaxial approach" of ankle joint was established by using 2.7 mm 30 擄arthroscope on 5 fresh specimens simulated by actual operation. Clinical application was performed in 3 cases (4 ankle joints). Results: the distance between the improved "coaxial approach" and small saphenous vein, flexor pollicis longus tendon and tibial nerve was 22.07 mm 5.39 mm and 6.27 mm respectively, and the distance between the original "coaxial approach" and small saphenous vein, flexor pollicis longus tendon and tibial nerve was 8.54 mm ~ 3.62 mm and 4.40 mm respectively. The static security of different heights of the "coaxial approach" is close. The results of statistical analysis show that the modified posterior "coaxial approach" is the most important anatomic structure in the posterior of ankle joint compared with other posterior approaches. The flexor pollicis longus tendon and flexor digitorum longus tendon were determined to be the internal marks of ankle arthroscopic operation. No piercing or touching of nerve and blood vessels. The clinical cases were followed up for an average of 5 months without complications. Conclusion: compared with the original "coaxial approach", the improved posterior "coaxial approach" has the advantages of higher safety, simpler operation and easier repetition.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2005
【分類號】：R322;R687.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前8條

1 呂占輝,王樹鋒,孔令貴,張克民,張耀,王來旭;關(guān)節(jié)鏡輔助下手術(shù)治療踝部骨折[J];骨與關(guān)節(jié)損傷雜志;2001年03期

2 董金波,史晨輝,王永明,劉維鋼,孫吉華,李江華,李寬新,王維山;關(guān)節(jié)鏡技術(shù)在踝關(guān)節(jié)疾病中的應(yīng)用[J];農(nóng)墾醫(yī)學(xué);2004年04期

3 滕學(xué)仁,丁利瓊;踝關(guān)節(jié)鏡檢查與鏡下手術(shù)治療[J];中國現(xiàn)代手術(shù)學(xué)雜志;2002年04期

4 石仕元,俞建英,胡云根;關(guān)節(jié)鏡下治療內(nèi)踝骨折22例[J];中國內(nèi)鏡雜志;2001年04期

5 倪磊,呂厚山,陳堅(jiān);踝關(guān)節(jié)炎的關(guān)節(jié)鏡手術(shù)(英文)[J];中國內(nèi)鏡雜志;2004年07期

6 李箭,苓石強(qiáng),蔣欣,龔錦源;踝關(guān)節(jié)鏡臨床應(yīng)用初探[J];中國醫(yī)刊;2001年09期

7 王立德,張羽飛,王福生,孫康;關(guān)節(jié)鏡下治療踝關(guān)節(jié)軟組織撞擊綜合征[J];中華骨科雜志;2000年04期

8 胡躍林,敖英芳,田得祥,于長隆,崔國慶,余家闊,焦晨,肖健,曲綿域;關(guān)節(jié)鏡在踝關(guān)節(jié)運(yùn)動(dòng)損傷中的作用[J];中國微創(chuàng)外科雜志;2003年01期

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