跟骨外侧血供的应用解剖观察
发布时间：2018-11-13 13:35
【摘要】： 目的:从应用解剖学角度,解剖观察跟骨外侧的血供,了解标准的跟骨外侧延长切口对跟骨外侧血供的影响。 方法:人体下肢常规防腐动脉内红色乳胶灌注标本和血管铸型标本,解剖观察跟骨外侧的血管来源、走行、分布和吻合。 结果:跟骨外侧血供是由跟外侧动脉、踝外侧动脉和跗外侧动脉提供的;跟外侧动脉来自腓动脉或/和胫后动脉,于跟骨结节水平距跟腱前缘距离8—15mm发出,血管直径为0.9—1.3mm;跟外侧动脉紧贴跟骨后上方和外侧壁迂曲行进,到第V跖骨基底附近与跗外侧动脉形成血管弓;同时还于腓骨尖远端经腓骨肌腱下与踝外侧动脉形成血管弓;三条主要血管和血管弓沿途发出众多分支血管相互交错吻合形成丰富的动脉血管网。 结论:1.跟外侧血供的主要血管有三条,其中以跟外侧动脉为主。三条主要血管之间相互吻合成比较粗大的血管弓,其分支本身以及分支之间存在着广泛的动脉吻合。2.跟外侧动脉于跟骨结节水平距跟腱前缘距离仅有8—15mm,靠近标准的“跟骨外侧延长切口”。3.标准的“跟骨外侧延长切口”中,切口的水平壁在某些标本中与跟外侧动脉和跗外侧动脉弓相交叉。4.建议:①跟骨外侧切口的近端垂直臂偏向跟骨结节前方5—7mm处;②“L”型拐角处角度应大于95—100o;③跟骨外侧切口水平臂应该位于足外侧皮肤和足底皮肤交界处,略偏足底处;④术中对跟骨体后关节面后方的“后窗”和跟骰关节处的暴露应避免锐性剥离。
[Abstract]:Objective: to observe the blood supply of lateral calcaneus from the perspective of applied anatomy, and to understand the effect of standard lateral calcaneal lengthening incision on lateral calcaneal blood supply. Methods: the origin, distribution and anastomosis of the blood vessels on the lateral side of the calcaneus were observed by anatomic observation. Results: the lateral blood supply of calcaneus was provided by lateral calcaneal artery, lateral malleolus artery and lateral tarsal artery. The lateral calcaneal artery came from the peroneal artery or / and the posterior tibial artery, and the diameter of the vessel was 0.9-1.3 mm, and the distance between the lateral calcaneal artery and the anterior edge of the Achilles tendon was 0.9-1.3 mm. The lateral calcaneal artery followed closely to the posterior superior calcaneus and the lateral wall of the calcaneus to form a vascular arch near the base of the V metatarsal bone and the lateral tarsal artery, and the vascular arch was also formed at the distal end of the fibula through the fibula tendon and the lateral malleolar artery. The three main blood vessels and the vascular arch along the way emit numerous branches of blood vessels interlaced and anastomosed to form a rich arterial network. Conclusion: 1. There are three main blood vessels in the lateral calcaneal blood supply, including the lateral calcaneal artery. The three main vessels anastomosed with each other to synthesize the thicker vascular arch, and the branches themselves and the branches had extensive arterial anastomosis. 2. The distance from the lateral calcaneal artery to the anterior edge of the Achilles tendon is only 8-15 mm, close to the standard "lateral lengthening incision of the calcaneus." In the standard lateral lengthened calcaneal incision, the horizontal wall of the incision intersects with the lateral calcaneal artery and the lateral tarsal artery arch in some specimens. 4. Suggestions: 1 the proximal vertical arm of the lateral calcaneal incision deviates to the 5-7mm in front of the calcaneal tubercle, the angle of the "L" type corner should be greater than 95-100o. (3) the horizontal arm of lateral calcaneal incision should be located at the junction of lateral foot skin and plantar skin, and the posterior window of posterior articular surface of calcaneal body and calcaneocuboid joint should be exposed to avoid sharp exfoliation.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R322
本文编号：2329267
[Abstract]:Objective: to observe the blood supply of lateral calcaneus from the perspective of applied anatomy, and to understand the effect of standard lateral calcaneal lengthening incision on lateral calcaneal blood supply. Methods: the origin, distribution and anastomosis of the blood vessels on the lateral side of the calcaneus were observed by anatomic observation. Results: the lateral blood supply of calcaneus was provided by lateral calcaneal artery, lateral malleolus artery and lateral tarsal artery. The lateral calcaneal artery came from the peroneal artery or / and the posterior tibial artery, and the diameter of the vessel was 0.9-1.3 mm, and the distance between the lateral calcaneal artery and the anterior edge of the Achilles tendon was 0.9-1.3 mm. The lateral calcaneal artery followed closely to the posterior superior calcaneus and the lateral wall of the calcaneus to form a vascular arch near the base of the V metatarsal bone and the lateral tarsal artery, and the vascular arch was also formed at the distal end of the fibula through the fibula tendon and the lateral malleolar artery. The three main blood vessels and the vascular arch along the way emit numerous branches of blood vessels interlaced and anastomosed to form a rich arterial network. Conclusion: 1. There are three main blood vessels in the lateral calcaneal blood supply, including the lateral calcaneal artery. The three main vessels anastomosed with each other to synthesize the thicker vascular arch, and the branches themselves and the branches had extensive arterial anastomosis. 2. The distance from the lateral calcaneal artery to the anterior edge of the Achilles tendon is only 8-15 mm, close to the standard "lateral lengthening incision of the calcaneus." In the standard lateral lengthened calcaneal incision, the horizontal wall of the incision intersects with the lateral calcaneal artery and the lateral tarsal artery arch in some specimens. 4. Suggestions: 1 the proximal vertical arm of the lateral calcaneal incision deviates to the 5-7mm in front of the calcaneal tubercle, the angle of the "L" type corner should be greater than 95-100o. (3) the horizontal arm of lateral calcaneal incision should be located at the junction of lateral foot skin and plantar skin, and the posterior window of posterior articular surface of calcaneal body and calcaneocuboid joint should be exposed to avoid sharp exfoliation.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R322
【引证文献】
相关期刊论文 前1条
1 邓志成;朱小华;王小平;许国泰;郭胜;;跟骨骨折内固定术后皮肤坏死原因及对策[J];海南医学;2013年01期
相关硕士学位论文 前2条
1 石连科;切开复位不同内固定方式治疗SandersⅡ、Ⅲ型跟骨骨折的疗效比较[D];山东中医药大学;2010年
2 胡钢;调节式整复外固定支架与AO跟骨钢板治疗跟骨关节内骨折的比较性研究[D];南京中医药大学;2007年
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