跖骨头软骨面下选择性截骨改善第二跖趾关节屈曲方向的解剖及临床研究

发布时间：2018-03-13 21:43

本文选题：跖骨　切入点：再造　出处：《青岛大学》2007年硕士论文　论文类型：学位论文

【摘要】： 目的探讨跖骨头关节面下选择性截骨改善跖趾关节屈曲方向的第二足趾移植再造拇手指的方法。方法1：成年干骨标本30具，对趾骨头关节面形态进行测量；2：成年足标本20例，对第一跖骨背动脉进行了详细解剖；3：临床6例携带第二足趾跖趾关节移植再造拇手指病例实际应用及长期随访研究。结果1：成年干骨测量结果：以跖趾关节的副韧带附着处为旋转中心，由背面至跖底面旋转半径渐增大至3.0±1.06mm，可进行骨头关节面下选择性截骨。2：第一跖骨背动脉的分型符合顾玉东的分型，并在距跖趾关节面5.0mm处进入跖骨。3：6例临床病例再造掌指关节伸直位到屈曲位被动活动范围最大85°，最小65°，平均75°，主动活动范围最大80°，，最小45°，平均65°，X线片复查，骨质愈合良好，无关节退性行变表现。结论跖骨头关节面下选择性截骨改善跖趾关节屈曲方向的第二足趾移植再造拇手指在解剖上可行，是改善拇手指再造后功能的良好方法。
[Abstract]:Objective to investigate the method of reconstructing thumb and finger by selective osteotomy under metatarsal head articular surface to improve the flexion direction of metatarsophalangeal joint. Methods 1: 30 adult dry bone specimens were used to measure the articular surface morphology of the toe bone in 20 cases of adult foot. The first metatarsal dorsal artery was dissected in detail. 6 cases of thumb and finger reconstruction carried the second toe and metatarsophalangeal joint transplantation and long-term follow-up study. Results: 1. Measurement of adult dry bone: the collateral ligament attachment of the metatarsophalangeal joint was taken as the center of rotation. The radius of rotation from the back to the bottom of the metatarsal surface gradually increased to 3.0 卤1.06mm, and the selective osteotomy under the articular surface of the bone was carried out. 2. The classification of the first dorsal metatarsal artery was consistent with Gu Yudong's classification. At 5.0mm from metatarsophalangeal articular surface to metatarsal bone. 3: 6 cases of reconstruction of metacarpophalangeal joint from straight position to flexion position, the range of passive motion was 85 掳, the minimum was 65 掳, the average was 75 掳, the active range was 80 掳, the minimum was 45 掳, and the average was 65 掳X-ray, the bone healed well. No degenerative changes were found. Conclusion selective subarticular osteotomy of metatarsal head to improve the flexion direction of metatarsophalangeal joint is anatomic feasible for reconstructing thumb and finger, and is a good method to improve the function of thumb and finger after reconstruction.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R322;R687.3

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