逆行带锁髓内钉治疗股骨远端骨折的应用解剖  被引量:9

Applied anatomy of treatment of distal femoral fractures with retrograde interlocking intramedullary nail

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作  者:易传安[1] 曹述铁[1] 张建波[1] 胡祥上[1] 饶利兵[1] 余中华[1] 田海文[1] 李荣霏[1] 徐志刚[2] 

机构地区:[1]怀化医学高等专科学校解剖学教研室 [2]怀化市第二人民医院骨科,湖南怀化418000

出  处:《中国临床解剖学杂志》2005年第2期160-162,共3页Chinese Journal of Clinical Anatomy

摘  要:目的:为带锁髓内钉治疗股骨远端骨折提供形态学基础。方法:①选用30例成人干燥股骨测量股骨内外侧髁、内外上髁、髁间窝有关数据进行统计分析。②20侧下肢标本解剖观测膝降动脉及隐神经髌下支的分支、分支等及两者的关系。结果:髁间窝呈U型占35%,V型占65%,此窝最宽处横径:左侧(1.98±0.36)cm, 右侧(2.06±0.29) cm;内侧髁后关节面宽,左侧(2.21±0.23) cm,右侧(2.34±0.29) cm;内、外上髁的距离,左侧(7.30±0.60)cm,右侧(7.43±0.57)cm。膝降动脉髌下支和隐神经髌下支呈紧密的伴行关系。隐神经在缝匠肌中下1/3交界点穿出,有上、下两支分布到膝关节前外侧皮肤。结论:术中注意这些解剖位置特点,避免损伤神经和血管,减少手术出血,防止并发症。Objective: To provide morphologic basis for treating distal femoral fracture with retrograde interlocking intramedullary nail. Methods: ①Medial condyle, lateral condyle, medial epicondyle, lateral epicondyle and intercondylat fossa of 30 adults' dry femurs were measured and analyzed. ②Descending genicular artery and its branches, distribution of infrapatellar branch of saphenous nerve and its relationship with the former were observed on 20 sides low limbs specimen. Results: ①The shape of intercondylar fossa was 'U' (35%) or 'V'(65%), the largest transverse diameter of intercondylar fossa was (1.98±0.36) cm (left) and (2.06±0.29) cm (right); The width of the back of articular surface of medial surface of lateral condyle was (2.28±0.31) cm (left) and (2.34±0.29) cm (right); The distance from medial epicondyle to lateral epicondyle was (7.30±0.60) cm (left) and (7.43±0.57)cm(right) respectively. ② The infrapatellar branch of descending genicular artery accompanied closely with saphenous nerve. The saphenous nerve sent out the upper and lower branch at the intersection point of 1/3 of the middle section and the lower section of sartorius, which distributed to the front area and the exterior area of knee joint. Conclusions: For preventing from damaging nerve, blood vessels and the happening of complication in the operation, anatomic characteristics as above should be concerned.

关 键 词:带锁髓内钉 股骨远端 手术入路 应用解剖 

分 类 号:R323.72[医药卫生—人体解剖和组织胚胎学] R683.42[医药卫生—基础医学]

 

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