小腿骨间膜结构及其上端裂孔的临床解剖  

Clinical anatomy on the structure of interosseous membrane of the crus and upper end hiatus

作　　者：邱龙恒 刘超 谭明洁 庄敏 张健 刘学敏[1] 李明[1] 李建伟[1] Qiu Longheng;Liu Chao;Tan Mingjie;Zhuang Min;Zhang Jian;Liu Xuemin;Li Ming;Li Jianwe(Department of Anatomy,Changzhi Medical College,Changzhi 046000,China;Changzhi Medical College,Changzhi 046000,China)

机构地区：[1]长治医学院解剖学教研室,长治046000 [2]长治医学院,长治046000

出　　处：《解剖学杂志》2019年第6期573-575,共3页Chinese Journal of Anatomy

基　　金：省级（山西省）大学生创新创业训练计划项目（2018399）

摘　　要：目的:研究小腿骨间膜上端裂孔的形态结构,为临床深入了解小腿骨间膜的功能,重建和避免胫前血管损伤提供形态学依据.方法:常规福尔马林固定小腿骨间膜标本40侧,观测胫、腓骨长度;骨间膜结构;骨间膜上端裂孔的形态;裂孔长轴腓侧近端至外踝的距离,计算骨间膜上端裂孔长轴腓侧近端至外踝距离与腓骨长的相关性.结果:骨间膜由膜性部和腱性部2部分组成.腱性部是一条斜型粗纤维束,位于骨间膜下1/2处,由走行一致的多条细小纤维构成,厚(0.32±0.12)cm,长(11.1±0.21)cm,与腓骨成角(20.60°±1.00°).上端裂孔成椭圆形,上端裂孔长轴长(2.71±1.35)cm、上端裂孔短轴长(1.91±0.21)cm、长轴近端腓侧至外踝最远处距离为(31.21±2.35)cm.胫骨长(34.21±2.36)cm、腓骨长(34.3±2.12)cm.骨间膜上端裂孔长轴腓侧近端至外踝距离与腓骨长正相关.结论:骨间膜对维持胫、腓骨轴向稳定,应力传递和防止小腿损伤后胫、腓骨移位具有重要作用.骨间膜上端裂孔的位置可由腓骨长推算而出.Objective:To study the morphological structure of the crural interosseous membrane and the superior interosseous membran hiatus so as to provide morphological basis to deeply understand the function of the crural interosseous membrane,reconstruction and prevention of tibial anterior vascular injury in clinical practice.Methods:40 crural interosseous membranes were fixed with formalin,then the length of tibia and fibula,interosseous membrane structure,appearance of the hiatus,and the distance from proximal lateral fibular end of the long axis of the hiatus to lateral extramalleolus were surveyed.Correlation between the distance from proximal bula to lateral malleolus and the length of bula was calculated.Results:Interosseous membrane was made up of the membranous and the tendinous part.The tendinous portion is an oblique bundle of coarse ber,located 1/2 way under the interosseous membrane,which is composed of several small bers that run in a uniform fashion.The thickness was(0.32±0.12)cm,and the length was(11.1±0.21)cm.The angle between the coarse fiber bundle and the fibula was(20.60°±1.00°).The upper hiatus was elliptic with the long axial length(2.71±1.35)cm,and the short axial length was(1.91±0.21)cm.The hiatal distance from proximal bular side to lateral malleolus of the long axis was(31.21±2.35)cm.Tibia length was(34.21±2.36)cm,and bula length was(34.3±2.12)cm.The distance from the long axis of the upper hiatus to the lateral malleolus was positively correlated with the length of the bula.Conclusion:Interosseous membrane plays an important role on maintaining the axial stability of tibio bula,propagation of pressure and preventing the displacement of tibio bula after fracture of the lower leg.The location of the superior interosseous membrane hiatus can be inferred by the length of the bula.

关 键 词：小腿 骨间膜 解剖学 轴向稳定 

分 类 号：R68[医药卫生—骨科学]