膝关节置换术后皮肤麻痹的解剖基础及相关临床研究

发布时间：2018-02-09 19:11

本文关键词： 隐神经髌下支膝关节置换术皮肤麻痹切口　出处：《中国临床解剖学杂志》2016年02期 　论文类型：期刊论文

【摘要】：目的探讨膝关节置换术后隐神经髌下支损伤所致的皮肤麻痹的解剖基础,改良手术切口,减少膝前皮肤麻木并发症。方法解剖观察12例成人尸体下肢标本,观测隐神经髌下支形态、神经束的走行及毗邻关系。设计改良膝外侧皮肤切口行膝关节置换手术入路进行临床验证,比较术后效果。结果解剖研究发现隐神经髌下支自缝匠肌穿出后,标本在髌骨中心平面神经距髌骨内侧缘约3.2 cm,75%标本有3束分支分布于髌骨下极及胫骨粗隆区域,以髌骨下极与粗隆连线中点为中心作圆,神经纤维主要分布左侧在第2象限,右侧在第1象限。临床研究采用改良膝关节外侧切口行膝关节置换术15例,方法可行,术后膝前皮肤麻木的发生率及范围较对照组减少,有统计学意义。结论根据膝关节隐神经髌下支解剖分布特点,改良膝前皮肤切口行膝关节置换术可减少术后膝前麻木。
[Abstract]:Objective to investigate the anatomical basis of skin palsy caused by subpatellar branch injury of saphenous nerve after knee arthroplasty and to improve the surgical incision to reduce the complications of skin numbness before knee. Methods 12 adult cadaveric lower limb specimens were dissected and observed. The shape of the subpatellar branch of the saphenous nerve, the path of the nerve bundle and the adjacent relationship were observed. The modified lateral skin incision of the knee was designed to perform knee arthroplasty for clinical verification. Results Anatomical study showed that after the subpatellar branch of the saphenous nerve was perforated from the sartorius muscle, there were 3 branches distributed in the subpatellar pole and the tibial trochanter region in 3 groups of 75% specimens of the central plane nerve of the patella from the medial edge of the patella. The nerve fibers were mainly distributed in the second quadrant on the left side and in the first quadrant on the right. 15 cases of knee arthroplasty were performed with modified lateral knee joint incision. The incidence and range of skin numbness in anterior knee after operation was significantly lower than that in the control group. Conclusion according to the anatomical distribution of the subpatellar branch of saphenous nerve of knee joint, the modified anterior skin incision of knee can reduce the postoperative numbness of the knee.
【作者单位】：暨南大学附属第一医院骨科;广州市第一人民医院关节外科;
【分类号】：R687.4;R322.7

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