跟内侧神经的形态特点与临床意义  

Anatomic characteristics and clinic significance of the medial calcaneal nerve

作　　者：唐举玉[1] 李康华[1] 任家伍[2] 刘俊[3] 刘洋波[3] 罗令[1] 

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中心,湖南衡阳421002

出　　处：《中南大学学报（医学版）》2010年第4期386-389,共4页Journal of Central South University ：Medical Science

基　　金：湖南省卫生厅科研基金(2005043)~~

摘　　要：目的:为临床选择跟内侧神经作为受区皮神经重建足跟感觉提供解剖依据。方法:选择成人尸体标本20个下肢,解剖跟内侧神经,观察其发出部位、形态、走行与分布情况,分别测量并记录跟内侧神经自胫神经发出部位及其属支分支处到内踝尖平面的距离和跟内侧神经主干及其主要分支的外径。结果:本组20侧标本中,跟内侧神经出现率为95%;跟内侧神经于内踝尖平面上3.3cm自胫神经发出,在内踝尖平面下0.3cm发出前、后支;前支分支支配跟内侧和足跟负重区前部皮肤,后支分支支配跟内侧和足跟负重区中后部皮肤;跟内侧神经主干及其前支、后支形态多类似圆柱形,其主干起始部外径平均为1.58mm,前支起始部外径平均为1.13mm,后支起始部外径平均为0.90mm。结论:跟内侧神经解剖较为恒定,有较粗的外径,起始部离足跟负重区有一定距离,具备重建足跟特别是足跟负重区感觉所要求的皮神经解剖学特点。Objective To provide anatomic evidence for choosing medial calcaneal nerve（MCN ） as recipient cutaneous nerve to rebuild heel sensation.Methods We chose 20 adult cadavers’ lower limbs,dissected the MCNs,observed their original sites,shapes,courses and distribution,and measured the perpendicular distance from original sites of MCNs from tibial nerve,original sites of their branches to the tip of medial malleolus,and the external diameters of their main trunks and branches.Results The frequency of the MCN was 95% in this array.All the MCNs arose from the tibial nerve at 3.3 cm up the horizontal plane of the tip of medial malleolus.They sent out anterior branches and posterior branches from 0.3 cm below the horizontal plane of the tip of medial malleolus on average.The anterior branch dominated the cutaneous sensation of the anterior part of the medial calcaneal and heel weight loading field,while the posterior branch dominated the sensation of the posterior and median part.The shape of MCNs,main trunks,anterior branches and posterior branches was like circular cylinder.At the origination,the external diameter of the MCN,the anterior branch and the posterior branch was 1.58,1.13 and 0.90 mm on average,respectively.Conclusion The anatomical position of MCN is relatively constant,and its external diameter is suitable.The initiation is not close to the heel weight loading area.Its anatomic characteristics meet the requirements of sensation recovery of the heel,especially the heel weight loading field.

关 键 词：足跟 皮神经 解剖 

分 类 号：R658.3[医药卫生—外科学]