跟外侧神经的形态特点及其临床意义  

The anatomic characteristics of the lateral calcaneal nerve and its clinical significance

作　　者：唐举玉[1] 李康华[1] 任家伍[2] 刘俊[3] 谢松林[3] 刘洋波[3] 夏小丹[3] 李匡文[3] 黄雄杰[3] 

机构地区：[1]中南大学湘雅医院骨科,长沙410008 [2]南华大学人体形态中心,湖南衡阳421001 [3]南华大学附属南华医院手外科,湖南衡阳421002

出　　处：《中国临床解剖学杂志》2009年第1期20-23,共4页Chinese Journal of Clinical Anatomy

基　　金：湖南省卫生厅科研基金资助项目(2005043)

摘　　要：目的:为临床选择跟外侧神经作为受区皮神经重建足跟感觉提供解剖依据。方法:20个成人尸体下肢标本,解剖显露腓肠内侧皮神经与腓肠外侧皮神经的会合部位至各支跟外侧神经的终末支;观察各支跟外侧神经的来源、发出部位、形态、走行、分支与分布情况;测量各支跟外侧神经自腓肠神经主干发出平面至外踝尖水平面的垂直距离及其起始部的外径。结果:大部分腓肠内、外侧皮神经于外踝尖平面上8.9cm会合成腓肠神经主干,于其后外侧部发出跟外侧神经1～3支;其中跟外侧神经第1支分别于外踝尖平面至其上方7.2cm发出,跟外侧神经发出后均垂直于足底平面向下走行,终支分布于足跟负重区外侧部皮肤;跟外侧神经及其分支多为类似圆柱形态;跟外侧神经有1～3支、直径分别为(1.62±0.45)mm、(1.11±0.37)mm和(0.85±0.39)mm。结论:跟外侧神经第1支解剖恒定,较为粗大,起始部离足跟外侧缘有一定距离,具备重建跟外侧感觉所要求的皮神经解剖学特点。Objective： To investigate the possibility of rebuilding sensation of the heel by using the lateral calcaneal nerve （LCN） as the recipient site＇s cutaneous nerve. Methods： Lower limbs of 20 adult cadavers were dissected to expose the converge site and the distal branches of medial and lateral sural cutaneous nerves. The origin, course and distribution of the LCN were observed. The distance from the planes where LCN originated to the tip of lateral malleolus＇transverse plane and the external diameters of LCN were measured. Results： Majority of medial sural cutaneous nerves and lateral sural cutaneous nerves converged into sural nerve on average 8.9cm above the plane of the tip of lateral malleolus, and then it sent out 1 -3 LCNs from its lateral side. The first lateral calcaneal nerve（LCN1） originated from sural nerve or lateral sural cutaneous nerve ranging from the plane of the tip of lateral malleolus upward about 7.2 cm. The LCN looked like a circular cylinder. All LCN coursed downward from the trunk of sural nerve, and the endings distributed over the lateral part of the lateral calcanears weight loading field. The external diameters of the three branches were 1.62 mm, 1.10 mm and 0.85 mm respectively. Conclusions： The LCN1 is an ideal cutaneous nerve for sensory reconstruction in the lateral calcaneal area, for it appears constantly, with extensive external diameter and a proper distance from its origin to the lateral calcaneal area.

关 键 词：足跟 皮神经 应用解剖 

分 类 号：R322.72[医药卫生—人体解剖和组织胚胎学]