摘要
目的为减少胫前动脉（ａｎｔｅｒｉｏｒ ｔｉｂｉａｌ ａｒｔｅｒｙ， ＡＴＡ）的损伤提供解剖学资料，探讨手术安全区。方法在３０具（６０侧）成人整尸上对ＡＴＡ、骨间膜孔等进行观测。结果ＡＴＡ与腘动脉的分叉点到骨间膜孔前侧缘距离为（１５．７± １．６）ｍｍ。ＡＴＡ第一段与腘动脉夹角的角度为１３５．５°±４．０°。ＡＴＡ经过骨间膜孔时第一段与第一段形成的夹角角度为１２２．４°± ９．０°。骨间膜孔呈卵圆形，纵径为（１７．１±０． ２） ｍｍ，横径为（ ８． ９ ± ０． ２） ｍｍ。在骨间膜孔 ＡＴＡ的上缘与腓骨头顶点距离为（ ５１． ２ ± ５． ４） ｍｍ。骨间膜孔 ＡＴＡ上缘与胫骨外侧髁上关节面外缘的距离为（６２． １±４． ０） ｍｍ。 ＡＴＡ与胫骨前缘的交叉点到内外踝连线中点的距离为（５．１± ０． ３） ｃｍ。本组共有 ３６例度开放性胫骨骨折病例，其中 ４例一期截肢，３２例用外固定器治疗。骨折愈合率８１％，平均愈合时间１０．５个月，感染率２５％。结论胫骨近段的前、中 １／３，中段的前 １／３和远段的后 １／３是股骨穿钉的安全区。
Objective To provide an anatomical description of the anterior tibial artery (ATA) in order to reduce the risk of its injury during surgery. Methods The ATA and the oval foramen of the interosseous membrane on the proximal tibia were studied with 60 specimens of the lower extremities procured from adult cadavers. Results The length in average of the ATA between its origin and the interosseous foramen was (15. 7 ± 1. 6) mm. The ATA originated from the popliteal artery at an angle of 135. 5 ± 4. 0, and formed an angle of 122. 4 ± 9. 0 as it went through the interosseous foramen. The foramen in the interosseous membrane was oval in shape, and measured (17.1 ± 0. 2) mm in length and (8. 9 ± 0. 2) mm in width. The interosseou foramen was located (51. 2 ± 5. 4) mm below the tip of the fibular head and (62. 1 ± 4. 0) mm below the lateral knee joint space. The ATA crossed over from the lateral to the anterior aspect of the tibia (5. I ± 0. 3 ) cm above the midpoint in between the malleolli. In 36 cases of type III fracture of the tibia, 4 were amputated at the initial visit, and 32 were treated by external fixation. The rate of bony union was 81%, with an average healing time of 10. 5 months. The infection rate was 25%. Conclusion The anterior and middle thirds of the proximal tibia, the anterior third of the middle section of the tibia and the posterior third of the distal tibia are the safe zones for tibial transfixation giving very little risk of injury of the anterior tibial artery.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1999年第12期712-715,共4页
Chinese Journal of Orthopaedics
