踝足部胫神经及其分支卡压的解剖学基础  

Anatomical study on compression of tibial nerve and it's branches in ankle and foot

作　　者：于光[1] 刘志刚[1] 林泉[2] 

机构地区：[1]吉林大学第一医院手足外科,吉林长春130021 [2]吉林大学第一医院整形外科,吉林长春130021

出　　处：《吉林大学学报（医学版）》2007年第5期908-910,共3页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅科技发展计划项目资助课题(200505232)

摘　　要：目的:探讨胫神经在踝足部卡压的因素及部位。方法:通过对20侧成人下肢标本的解剖,观测胫神经在踝足部的分支及其足底内外侧管,并测量相关数据。结果:①展肌腱性部分位于肌腹下面,展肌腱性部分长(8.62±0.79)cm,宽(3.01±0.30)cm,厚(0.24±0.02)cm,腱性部分构成了足底内外侧管表面;足底内外侧神经走行于足底内外侧管,足底内侧管长(4.58±0.41)cm,横径(1.11±0.10)cm;足底外侧管长(2.58±0.23)cm,横径(0.96±0.08)cm;②在足跟内侧跟内侧神经行走于一独立管道,即跟管,跟管长(3.03±0.21)cm,横径(1.07±0.09)cm。结论:在足底内、外侧管,跟管处胫神经分支可被卡压;对踝管综合征的患者进行神经松解时,除了切开屈肌支持带松解胫神经,还要打开足底内外侧管及跟管对胫神经分支进行松解,特别是对伴有单一分支卡压症状的患者。Objective To observe the branches and distribution of the tibial nerve and analyze the compressed position of it. Methods Twenty sides of adult cadavers were anatomized and the tibial nerve branches in ankle, foot, the internal and external plantar tunnel were observed. Correlated data was measured and recorded. Results ① The tendinous part of abductor ballucis muscle that was located under the muscle and consisted the surface of the internal and external plantar tunnel was （8.62±0.79） cm in length , （3.01±0.30） cm in width, and the thickness of it was about （0.24±0.02） cm. The internal and external nerves were located in the internal and external tunnel. The length of the internal tunnel was about （4.58±0.41） cm, and the diameter was （1.11± 0.10） cm. The length of the external tunnel was about （2.58 ± 0.23） cm, the diameter was about （0.96 ± 0.08） cm. ② Internal hell nerve was in an isolated tunnel interior the hell, which was the hell tunnel. The length of the hell tunnel was about （3.03±0.21） cm, the diameter was （1.07±0.09） cm. Conclusion The tibial nerve branches can be compressed at internal, external plantar tunnel or the heel tunnel. When making neurolysis of the tibial nerve for tarsal tunnel syndrome patients, except for the flexor retinaculum, the internal and external plantar tunnel and the hell tunnel should also be decompressed especially for the patients with the symptom of compressed single branch .

关 键 词：踝管 胫神经 解剖 神经卡压综合征 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]