胫骨远端内侧入路钢板螺钉危险区解剖研究  

Anatomical Study of the Danger Zone for Locking Screw Placement of Distal Tibia Fractures by Anteromedial Approach Using Locking Plate

作　　者：张雄 王晓冬[1] 孙大兵 乔晓霞 张洁 王建忠[1] 李聪杰[1] 高文山[1] Zhang Xiong;Wang Xiaodong;Sun Dabing(Department of Orthopedics,Affiliated Hospital of Hebei University Orthopedics,Baoding 071000 China)

机构地区：[1]河北大学附属医院骨科,河北保定071000

出　　处：《实用骨科杂志》2018年第5期431-433,437,共4页Journal of Practical Orthopaedics

基　　金：2015年河北省政府资助省级临床医学优秀人才项目(361007);2016年河北大学研究生创新资助项目(X201741)

摘　　要：目的明确胫骨远端内侧钢板固定操作时对胫前动脉的风险。方法对10具新鲜小腿标本行胫骨远端内侧入路微创钢板固定实验,模拟术中操作以确定钢板螺钉与胫前动脉之间的解剖关系。结果胫骨远端内侧入路钢板螺钉固定对胫前动脉的危险区域在胫骨内踝上(15.4±3.3)cm,换算成胫骨长度百分比位置即胫骨内踝上(40.0±8.4)%;双侧99%的可信区间为(36.6,42.4)%。结论胫骨远端内侧入路时,钻孔及螺钉固定操作可能会损伤胫前动脉,笔者提出胫骨远端内侧入路钢板螺钉危险区的概念,指导临床手术,减少术中的医源性损伤。Objective To identify the danger zone in the treatment of distal tibia fractures using locking plate by anteromedial approach.Methods This study was performed on 10 fresh lower limbs.Each leg was fixed with 14-hole plate.Clearing the application of medial distal tibia anatomical plate and screw fixation distribution region and influence on the anterior tibial artery.Results The average tibia length was 38.6 cm.The danger zone for the anterior tibial artery averaged of the tibia length from the medial malleolus（15.4±3.3）cm（99% CI：36.6,42.4）.Conclusion from this anatomy study,the danger zone could be determined as a percentage of tibia length,then the injury could be avoided through the operation.

关 键 词：胫骨远端骨折 胫前动脉 应用解剖学 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]