【摘要】：目的：探討一種能夠解決距骨骨折、骨不連及骨壞死的新方法。方法：對(duì)10例(20側(cè))成人尸體下肢標(biāo)本行血管解剖觀測(cè),觀察踝上支動(dòng)脈的發(fā)出點(diǎn),行走路線(xiàn),長(zhǎng)度,外徑及其與鄰近血管間的吻合關(guān)系,并在8例距骨壞死患肢行骨瓣移位手術(shù)觀察。結(jié)果：踝動(dòng)脈在內(nèi)外踝中點(diǎn)上方(3.3±0.6)cm處始于脛前動(dòng)脈,與脛前動(dòng)脈呈35。-60。夾角發(fā)出后延骨面前行一段后分叉成升支和降支。其降支外徑(1.2±0.3)mm,長(zhǎng)(4.1±0.4)cm,伴行靜脈2條,其外徑分別為(1.4±0.3)mm、(1.1±0.2)mm,該血管為一骨皮支,降支下行與附A血管交通,降支有一營(yíng)養(yǎng)動(dòng)脈進(jìn)入脛骨遠(yuǎn)端。結(jié)論：以踝上支降支動(dòng)脈提供血液的脛骨活骨塊,是修復(fù)距骨骨折、骨不連及骨壞死等總結(jié)出一種簡(jiǎn)便易行的手術(shù)方法。目的：探討脛前動(dòng)脈踝上支降支蒂脛骨遠(yuǎn)端骨瓣移位治療距骨缺血性壞死的臨床效果。方法：2010年5月～2013年10月收治8例距骨創(chuàng)傷性距骨ANT患者,均采用脛前A踝上降支提供血液的脛骨遠(yuǎn)端活骨塊轉(zhuǎn)移治療,手術(shù)后患足石膏固定與90。位4周。結(jié)果：隨訪(fǎng)半年至兩年,平均一年。8例患者術(shù)后都得到理想恢復(fù),最終隨訪(fǎng)檢查踝關(guān)節(jié)功能依據(jù)Kenwight評(píng)估,其中優(yōu)6例,良2例。結(jié)論：該骨瓣血管恒定,血供豐富,手術(shù)難度低,是治療距骨缺血壞死的較理想方法。
[Abstract]:Objective: to explore a new method to solve talus fracture, nonunion and osteonecrosis. Methods: vascular anatomy was performed on 10 cadavers (20 sides) of adult cadavers, and the origin, route, length, external diameter and anastomosis with adjacent vessels of the superior malleolus artery were observed. Bone flap transposition was performed in 8 patients with osteonecrosis. Results: the medial and lateral malleolus medial point of the ankle artery (3.3 鹵0.6) cm began from the anterior tibial artery and was 35.-60 with the anterior tibial artery. The angle sends out a segment of the dehiscent bone in front of it to form the ascending and descending branches. The descending branch was (1.2 鹵0.3) mm in diameter and (4.1 鹵0.4) cm in length. The external diameter of the descending branch was (1.4 鹵0.3) mm, () 鹵(1.1 鹵0.20) mm, and the external diameter of the descending branch was (1.4 鹵0.3) mm, (1.1 鹵0.2) mm. The descending branch was communicating with A vessel, and a nutrient artery entered the distal tibia. Conclusion: the living bone mass of tibia supplied with blood from descending branch of superior malleolus branch is a simple and convenient method to repair talus fracture, nonunion and osteonecrosis. Objective: to investigate the clinical effect of distal tibial bone flap pedicled with descending branch of superior malleolus branch of anterior tibial artery in the treatment of avascular necrosis of talus. Methods: from May 2010 to October 2013, 8 patients with traumatic talus ant were treated with bone metastasis of distal tibia with blood from the superior descending branch of the anterior tibial A ankle. The patients were treated with plaster fixation and 90% plaster fixation after operation. Position 4 weeks. Results: the patients were followed up for half a year to two years, with an average of one year. The ankle function was evaluated according to Kenwight, 6 cases were excellent and 2 cases were good. Conclusion: this bone flap is an ideal method for the treatment of avascular necrosis of talus.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R687.34

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