内窥镜治疗踝管综合症的解剖学研究

发布时间：2018-04-24 22:17

本文选题：内窥镜 + 踝管综合征　；参考：《吉林大学》2006年硕士论文

【摘要】：踝管综合征,又称跖管综合征,是指胫神经或其分支经过胫骨内踝后面屈肌支持带(又称分裂韧带)下面的骨纤维管时,受压而引起的症候群,本病在临床上不易引起注意,经常误诊。传统的方法都是采取手术方法,操作复杂,最重要的是损伤很大,预后并发症也较多。二十世纪后期随着光学仪器的不断产生和高科技手段的面世,内窥镜技术在临床各领域已广泛应用,而在周围神经的诊断和治疗方面的应用尚属起步阶段。采取内窥镜手术治疗腕管和肘管综合征具有操作迅捷出血少,不用止血带,术后早期即可功能联系,尤其是双侧手术的患者,减少了术后生活上的不便和痛苦,可很快恢复日常生活活动。目前国内外的文献还没有报道利用内窥镜技术进行踝管综合征的诊断和治疗,分析原因为踝管不同腕管和肘管,管道呈“L”型,踝关节活动范围小,无法通过踝关节的趾屈使管道变直,管道内结构复杂,利用chow两点法无法彻底松解胫神经。所以根据踝管的解剖特点我们通过解剖学研究设计一种内窥镜松解踝管的手术入路:即三点(内踝尖至跟腱止点内侧缘连线中垂线上4.5cm;内踝尖至跟骨结节连线中点;跟骨结节至第一跖趾关节内侧缘连线中点)入路、分段松解,并在新鲜尸体上取得成功。这也是本课题的创新点。
[Abstract]:Ankle tunnel syndrome, also known as metatarsal canal syndrome, refers to the syndrome caused by compression of the tibial nerve or its branches under the osseous fibrous canal under the posterior flexor flexor band (also known as the splittal ligament) of the tibial medial ankle, which is not easily noticed clinically. Often misdiagnosed. The traditional methods are surgical methods, the operation is complex, the most important is that the injury is very large, the prognosis complications are also more. In the late 20th century, with the development of optical instruments and the advent of high-tech means, endoscopy has been widely used in clinical fields, but its application in the diagnosis and treatment of peripheral nerves is still in its infancy. Endoscopic treatment of carpal tunnel and cubital tunnel syndrome has the advantages of less rapid bleeding, no tourniquet, early postoperative functional contact, especially bilateral surgery, which reduces the inconvenience and pain in postoperative life. Can resume daily life activity quickly. At present, there is no report on the diagnosis and treatment of ankle tunnel syndrome by endoscope in domestic and foreign literature. The causes are different carpal tunnel and cubital tunnel of ankle tunnel, the canal is "L" type and the range of ankle joint motion is small. The tube can not be straightened through the toe flexion of ankle joint, and the structure of the pipe is complex. The tibial nerve can not be completely released by chow two-point method. Therefore, according to the anatomical characteristics of the ankle canal, we designed an operative approach to release the ankle canal by endoscope through anatomical research: three points (4.5cm above the vertical line between the medial ankle tip and the Achilles tendon insertion point, the midpoint between the medial ankle tip and the calcaneal tubercle line), and the middle point from the medial ankle tip to the calcaneal tubercle line. Calcaneal nodules to the medial margin of the first metatarsophalangeal joint) approach, segmental release, and success on fresh cadavers. This is also the innovation of this topic.
【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】：R687.2;R322

【共引文献】