“跖袖”的解剖学研究及临床意义

发布时间：2018-03-20 07:28

本文选题：跖袖　切入点：应用解剖　出处：《吉林大学》2006年硕士论文　论文类型：学位论文

【摘要】：拇外翻是指拇趾外翻及第一跖骨内翻,是一种最常见的下肢结构性畸形。多年来,这个课题已得到广泛探讨和研究,无数矫形外科和足外科医生集中精力研究这种病变的病因诊断及治疗矫形。治疗拇外翻的手术方式不下100种,主要是缓解症状,纠正足部解剖异常,延缓疾病的进一步发展。认识拇外翻足的复杂三维畸形有助于对其进行的治疗。对于拇外翻伴有足弓塌陷且需要做手术的患者,解决前足畸形的同时,也需考虑肌力平衡和重建足弓的问题。虽然许多学者从X线的角度研究拇外翻与足弓的关系,但是均未从解剖的角度去揭示拇外翻的真正本质。为此,本研究通过对20例新鲜成人标本的解剖研究发现,“跖袖”的动力平衡失调,特别是拇展肌与拇收肌通过籽骨系统导致的平衡失调是拇外翻形成的核心机制。随之拇短伸肌、拇短屈肌、拇长伸肌及拇长屈肌解剖关系发生变异,加重拇外翻畸形。因此,我科设计的拇展肌与拇收肌移位吻合矫正拇外翻的新术式在矫正拇外翻畸形的同时,恢复了“跖袖”和前足的生理解剖结构及生物力学功能,重建前足横弓,适于临床推广使用。
[Abstract]:Hallux valgus refers to the hallux valgus and the first metatarsal varus, which is one of the most common structural deformities of the lower extremity. Numerous orthopaedic and foot surgeons have focused on the etiological diagnosis and treatment of this disease. There are no fewer than 100 surgical methods for the treatment of hallux valgus, mainly to relieve symptoms and correct anatomic abnormalities of the foot. Delay the further development of the disease. Understanding the complex three-dimensional deformities of hallux valgus feet is helpful to its treatment. For patients with hallux valgus accompanied by collapse of the foot arch and requiring surgery, the treatment of the forefoot deformity is at the same time, It is also necessary to consider the balance of muscle force and the reconstruction of foot arch. Although many scholars have studied the relationship between hallux valgus and foot arch from the perspective of X-ray, none of them has revealed the true essence of hallux valgus from an anatomical point of view. In this study, the anatomic study of 20 fresh adult specimens showed that the dynamic balance of "plantar cuff", especially the imbalance between abductor pollicis muscle and adductor hallucis muscle through the seed bone system, was the core mechanism of hallux valgus formation, and the extensor pollicis brevis muscle was followed. The anatomic relationship among flexor pollicis brevis, extensor pollicis longus and flexor pollicis longus was changed, which aggravated hallux valgus malformation. The "plantar sleeve" and forefoot's physiological and anatomical structure and biomechanical function were restored, and the transverse arch of forefoot was reconstructed, which is suitable for clinical application.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R322;R682

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