【摘要】： 目的:從應(yīng)用解剖學(xué)角度,解剖觀察跟骨外側(cè)的血供,了解標(biāo)準(zhǔn)的跟骨外側(cè)延長(zhǎng)切口對(duì)跟骨外側(cè)血供的影響。 方法:人體下肢常規(guī)防腐動(dòng)脈內(nèi)紅色乳膠灌注標(biāo)本和血管鑄型標(biāo)本,解剖觀察跟骨外側(cè)的血管來源、走行、分布和吻合。 結(jié)果:跟骨外側(cè)血供是由跟外側(cè)動(dòng)脈、踝外側(cè)動(dòng)脈和跗外側(cè)動(dòng)脈提供的;跟外側(cè)動(dòng)脈來自腓動(dòng)脈或/和脛后動(dòng)脈,于跟骨結(jié)節(jié)水平距跟腱前緣距離8—15mm發(fā)出,血管直徑為0.9—1.3mm;跟外側(cè)動(dòng)脈緊貼跟骨后上方和外側(cè)壁迂曲行進(jìn),到第V跖骨基底附近與跗外側(cè)動(dòng)脈形成血管弓;同時(shí)還于腓骨尖遠(yuǎn)端經(jīng)腓骨肌腱下與踝外側(cè)動(dòng)脈形成血管弓;三條主要血管和血管弓沿途發(fā)出眾多分支血管相互交錯(cuò)吻合形成豐富的動(dòng)脈血管網(wǎng)。 結(jié)論:1.跟外側(cè)血供的主要血管有三條,其中以跟外側(cè)動(dòng)脈為主。三條主要血管之間相互吻合成比較粗大的血管弓,其分支本身以及分支之間存在著廣泛的動(dòng)脈吻合。2.跟外側(cè)動(dòng)脈于跟骨結(jié)節(jié)水平距跟腱前緣距離僅有8—15mm,靠近標(biāo)準(zhǔn)的“跟骨外側(cè)延長(zhǎng)切口”。3.標(biāo)準(zhǔn)的“跟骨外側(cè)延長(zhǎng)切口”中,切口的水平壁在某些標(biāo)本中與跟外側(cè)動(dòng)脈和跗外側(cè)動(dòng)脈弓相交叉。4.建議:①跟骨外側(cè)切口的近端垂直臂偏向跟骨結(jié)節(jié)前方5—7mm處;②“L”型拐角處角度應(yīng)大于95—100o;③跟骨外側(cè)切口水平臂應(yīng)該位于足外側(cè)皮膚和足底皮膚交界處,略偏足底處;④術(shù)中對(duì)跟骨體后關(guān)節(jié)面后方的“后窗”和跟骰關(guān)節(jié)處的暴露應(yīng)避免銳性剝離。
[Abstract]:Objective: to observe the blood supply of lateral calcaneus from the perspective of applied anatomy, and to understand the effect of standard lateral calcaneal lengthening incision on lateral calcaneal blood supply. Methods: the origin, distribution and anastomosis of the blood vessels on the lateral side of the calcaneus were observed by anatomic observation. Results: the lateral blood supply of calcaneus was provided by lateral calcaneal artery, lateral malleolus artery and lateral tarsal artery. The lateral calcaneal artery came from the peroneal artery or / and the posterior tibial artery, and the diameter of the vessel was 0.9-1.3 mm, and the distance between the lateral calcaneal artery and the anterior edge of the Achilles tendon was 0.9-1.3 mm. The lateral calcaneal artery followed closely to the posterior superior calcaneus and the lateral wall of the calcaneus to form a vascular arch near the base of the V metatarsal bone and the lateral tarsal artery, and the vascular arch was also formed at the distal end of the fibula through the fibula tendon and the lateral malleolar artery. The three main blood vessels and the vascular arch along the way emit numerous branches of blood vessels interlaced and anastomosed to form a rich arterial network. Conclusion: 1. There are three main blood vessels in the lateral calcaneal blood supply, including the lateral calcaneal artery. The three main vessels anastomosed with each other to synthesize the thicker vascular arch, and the branches themselves and the branches had extensive arterial anastomosis. 2. The distance from the lateral calcaneal artery to the anterior edge of the Achilles tendon is only 8-15 mm, close to the standard "lateral lengthening incision of the calcaneus." In the standard lateral lengthened calcaneal incision, the horizontal wall of the incision intersects with the lateral calcaneal artery and the lateral tarsal artery arch in some specimens. 4. Suggestions: 1 the proximal vertical arm of the lateral calcaneal incision deviates to the 5-7mm in front of the calcaneal tubercle, the angle of the "L" type corner should be greater than 95-100o. (3) the horizontal arm of lateral calcaneal incision should be located at the junction of lateral foot skin and plantar skin, and the posterior window of posterior articular surface of calcaneal body and calcaneocuboid joint should be exposed to avoid sharp exfoliation.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2006
【分類號(hào)】：R322

【引證文獻(xiàn)】

相關(guān)期刊論文 前1條

1 鄧志成;朱小華;王小平;許國(guó)泰;郭勝;;跟骨骨折內(nèi)固定術(shù)后皮膚壞死原因及對(duì)策[J];海南醫(yī)學(xué);2013年01期

相關(guān)碩士學(xué)位論文 前2條

1 石連科;切開復(fù)位不同內(nèi)固定方式治療SandersⅡ、Ⅲ型跟骨骨折的療效比較[D];山東中醫(yī)藥大學(xué);2010年

2 胡鋼;調(diào)節(jié)式整復(fù)外固定支架與AO跟骨鋼板治療跟骨關(guān)節(jié)內(nèi)骨折的比較性研究[D];南京中醫(yī)藥大學(xué);2007年

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本文編號(hào)：2329267