踝上动脉降支为蒂胫骨骨瓣移位术的解剖及应用

发布时间：2018-07-14 20:08

【摘要】：目的：探讨一种能够解决距骨骨折、骨不连及骨坏死的新方法。方法：对10例(20侧)成人尸体下肢标本行血管解剖观测,观察踝上支动脉的发出点,行走路线,长度,外径及其与邻近血管间的吻合关系,并在8例距骨坏死患肢行骨瓣移位手术观察。结果：踝动脉在内外踝中点上方(3.3±0.6)cm处始于胫前动脉,与胫前动脉呈35。-60。夹角发出后延骨面前行一段后分叉成升支和降支。其降支外径(1.2±0.3)mm,长(4.1±0.4)cm,伴行静脉2条,其外径分别为(1.4±0.3)mm、(1.1±0.2)mm,该血管为一骨皮支,降支下行与附A血管交通,降支有一营养动脉进入胫骨远端。结论：以踝上支降支动脉提供血液的胫骨活骨块,是修复距骨骨折、骨不连及骨坏死等总结出一种简便易行的手术方法。目的：探讨胫前动脉踝上支降支蒂胫骨远端骨瓣移位治疗距骨缺血性坏死的临床效果。方法：2010年5月～2013年10月收治8例距骨创伤性距骨ANT患者,均采用胫前A踝上降支提供血液的胫骨远端活骨块转移治疗,手术后患足石膏固定与90。位4周。结果：随访半年至两年,平均一年。8例患者术后都得到理想恢复,最终随访检查踝关节功能依据Kenwight评估,其中优6例,良2例。结论：该骨瓣血管恒定,血供丰富,手术难度低,是治疗距骨缺血坏死的较理想方法。
[Abstract]:Objective: to explore a new method to solve talus fracture, nonunion and osteonecrosis. Methods: vascular anatomy was performed on 10 cadavers (20 sides) of adult cadavers, and the origin, route, length, external diameter and anastomosis with adjacent vessels of the superior malleolus artery were observed. Bone flap transposition was performed in 8 patients with osteonecrosis. Results: the medial and lateral malleolus medial point of the ankle artery (3.3 卤0.6) cm began from the anterior tibial artery and was 35.-60 with the anterior tibial artery. The angle sends out a segment of the dehiscent bone in front of it to form the ascending and descending branches. The descending branch was (1.2 卤0.3) mm in diameter and (4.1 卤0.4) cm in length. The external diameter of the descending branch was (1.4 卤0.3) mm, () 卤(1.1 卤0.20) mm, and the external diameter of the descending branch was (1.4 卤0.3) mm, (1.1 卤0.2) mm. The descending branch was communicating with A vessel, and a nutrient artery entered the distal tibia. Conclusion: the living bone mass of tibia supplied with blood from descending branch of superior malleolus branch is a simple and convenient method to repair talus fracture, nonunion and osteonecrosis. Objective: to investigate the clinical effect of distal tibial bone flap pedicled with descending branch of superior malleolus branch of anterior tibial artery in the treatment of avascular necrosis of talus. Methods: from May 2010 to October 2013, 8 patients with traumatic talus ant were treated with bone metastasis of distal tibia with blood from the superior descending branch of the anterior tibial A ankle. The patients were treated with plaster fixation and 90% plaster fixation after operation. Position 4 weeks. Results: the patients were followed up for half a year to two years, with an average of one year. The ankle function was evaluated according to Kenwight, 6 cases were excellent and 2 cases were good. Conclusion: this bone flap is an ideal method for the treatment of avascular necrosis of talus.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.34

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