吻合血管神经的（？）、趾短伸肌移植重建手内肌的解剖学与组织化学研究

发布时间：2018-04-05 00:11

本文选题：(足母)趾短伸肌　切入点：腓深神经　出处：《第一军医大学》2006年硕士论文

【摘要】：一、研究的目的及意义臂丛神经根性撕脱伤一直是创伤骨科临床的难题，尤其全臂丛或下臂丛根性撕脱伤，，目前尚无行之有效的修复方法以恢复有用的手内肌功能。借鉴吻合血管、神经的(?)、趾短伸肌皮瓣移植重建严重火器性手部损伤后拇对掌及内收功能的成功经验，应用吻合血管、神经的(?)、趾短伸肌移植重建臂丛根性撕脱伤，尤其是陈旧性损伤手内在肌功能可能是一种有效的治疗方法。但由于臂丛根性撕脱伤的特殊性，在手腕部受区缺乏可供直接缝接的运动性移位神经支，而可供缝接的运动性移位神经支的平面在上臂部或肘部(如下臂丛根性撕脱伤)。因此，研究(?)、趾短伸肌的运动神经支在腓深神经中的定位及其可逆行分离的最大长度等相关解剖学基础，有助于确立行选择性运动性神经支(束)移位直接缝接或经神经移植缝接(?)、趾短伸肌的运动神经支，这也是(?)、趾短伸肌移植重建臂丛根性撕脱伤后手内在肌功能这一新术式能否取得良好疗效的关键。二、材料和方法 1、显微解剖研究：采用完整的中国成人尸体进行研究(由南方医科大学解剖学研究所提供)，尸体经甲醛防腐固定、红色乳胶动脉灌注。共采用尸体下肢标本30侧，其中男性20侧，女性10侧。于(?)、趾短伸肌起止点对其进行完整解剖，进行神经血管修洁，充分清除肌表面的脂肪和筋膜，对(?)、趾短伸肌的大体形态——长度、厚度及宽
[Abstract]:The purpose and significance of the researchBrachial plexus root avulsion is always a difficult problem in orthopedic trauma, especially in total brachial plexus or lower brachial plexus root avulsion.The successful experience of reconstruction of thumb palmar and adductive function after severe firearm injury was studied by using vascular anastomosis, nerve anastomosis and transplantation of extensor digitorum brevis musculocutaneous flap for reconstruction of brachial plexus root avulsion injury by anastomosis of blood vessels and nerve, transplantation of extensor digitorum brevis muscle to reconstruct root avulsion of brachial plexus.In particular, old injury of the intrinsic muscle function of the hand may be an effective treatment.However, because of the particularity of brachial plexus root avulsion, there is a lack of motor transposition nerve branch in the recipient region of wrist, and the plane of motor transposition nerve branch can be sutured in upper brachial part or elbow (as follows, brachial plexus root avulsion injury.Therefore, the location of motor nerve branch of extensor digitorum brevis in the deep peroneal nerve and the maximum length of retrograde separation were studied.It is helpful to establish the motor nerve branch of the extensor digitorum brevis muscle by selective transposition of motor nerve branch (bundle) or through nerve graft suture.This is also the key to the success of the new method of reconstruction of the intrinsic muscle function of the hand after brachial plexus root avulsion injury by the transplantation of extensor digitorum brevis.II. Materials and methods1. Microanatomical study:The complete cadavers of Chinese adults were studied (provided by the Institute of Anatomy, Southern Medical University). The cadavers were fixed with formaldehyde and infused with red latex artery.A total of 30 cadaveric lower extremities were collected, including 20 males and 10 females.At the beginning and ending point of extensor digitorum brevis, complete dissection was carried out, nerve and blood vessels were cleaned up, fat and fascia on muscle surface were removed fully, and the gross morphology, length, thickness and width of extensor digitorum brevis were studied.
【学位授予单位】：第一军医大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R322;R651.3

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