距骨血供与手术入路关系的应用解剖学研究  

Applied anatomy on blood supply and operative approaches of talus

作　　者：李元洲[1] 杨茂伟[1] 杨成刚[1] 郭宝磊[1] 王振鹏[1] 

机构地区：[1]中国医科大学附属第一医院骨科,沈阳110001

出　　处：《中国临床解剖学杂志》2012年第2期127-130,共4页Chinese Journal of Clinical Anatomy

摘　　要：目的探讨距骨血管分布及其与手术入路之间的关系。方法 20例成人足踝部新鲜尸体标本,红色乳胶血管灌注后进行踝关节分层次解剖和制作血管铸行标本,测量供应距骨主要各动脉起点的外径,观察距骨血供的血管来源、走行、分布,同时了解各动脉之间的吻合情况。结果距骨血供主要来自胫后动脉发出的三角支,其管径为(0.98±0.04)mm、后结节支,管径为(0.25±0.06)mm、跗骨管动脉,管径为(1.02±0.1)mm,这些分支主要走行于踝关节的内、后内侧,由胫前动脉发出颈上支,管径(0.3±0.1)mm、跗骨窦动脉,管径(1.08±0.6)mm,分布于踝关节的前侧,由腓动脉发出的跟支细小,管径为(0.42±0.18)mm、穿支,管径为(0.69±0.12)mm,主要分布于踝关节的后外侧,同时在足踝铸行标本上还发现这些分支之间形成丰富的血管吻合。结论踝关节的前内侧入路介于胫前动脉和三角动脉之间,对距骨的血液供应损伤影响最小。Objective To explore arterial supply of the talus and the related operative approaches.Methods 20 fresh adult foot specimens,with no vascular disease,and injected with red latex,were used in this study.Ankle joints were dissected at different levels,followed by the observation and comparison with the casting specimens.We measured external diameter of main arteries nourishing talus,and dissected it＇s origin,courses,distributions and anastomoses. Results Talus was mainly supplied by the deltoid branch,posterior tubercule branch,and the tarsal canal artery of the posterior tibial artery with the diameter of（0.98±0.04）mm,（0.25±0.06）mm and（1.02±0.1）mm,respectively.Those branches distributed mainly to the posteromedial aspect of the ankle joint.The superior cervical branch and the tarsal canal artery issued from the anterior tibial artery,with the diameter of（0.3±0.1）mm and（1.08±0.6）mm,distributed to the anterior aspect of the ankle joint.The calcaneal branch and the perforating branch arised from the peroneal artery,with the diameter of（0.42±0.18）mm and（0.69±0.12）mm,distributed to posterolateral aspect of the ankle joint.Extensive vascular anastomoses among them were recognized on the cast specimens of foot and ankle.Conclusions The anteromedial approach to the talus between the anterior tibial artery and the deltoid artery causes least damage to talus blood supply.

关 键 词：距骨 手术入路 血液供应 应用解剖 

分 类 号：R323.72[医药卫生—人体解剖和组织胚胎学]