通道辅助微创吻合技术治疗急性跟腱断裂中保护套筒与腓肠神经位置关系解剖研究  

Anatomical research of positional relationship between protective channel and sural nerve during Achilles tendon repair using channel assisted minimally invasive repair technique

作　　者：王中鹤 曹文豪 齐红哲 孔令通 刘浩宇 陈辰 李连华 孙丽君 陈华 WANG Zhonghe;CAO Wenhao;QI Hongzhe;KONG Lingtong;LIU Haoyu;CHEN Chen;LI Lianhua;SUN Lijun;CHEN Hua(Graduate School,Ningxia Medical University,Yinchuan Ningxia,750004,P.R.China;Orthopedic Department Unit 1,the First Medical Center of Chinese PLA General Hospital,Beijing,100853,P.R.China;Senior Department of Orthopedics,the Fourth Medical Center of Chinese PLA General Hospital,Beijing,100142,P.R.China)

机构地区：[1]宁夏医科大学研究生院,银川750004 [2]中国人民解放军总医院第一医学中心骨科一病区,北京100853 [3]中国人民解放军总医院第四医学中心骨科医学部,北京100142

出　　处：《中国修复重建外科杂志》2024年第11期1325-1329,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：中国人民解放军总医院企事业单位合作课题-骨科类医疗器械产品临床前相关研究(YQCH201601);173基础加强计划重点基础研究项目(2020-JCJD-ZD-264-4-12)。

摘　　要：目的基于尸体标本解剖观测通道辅助微创吻合技术(channel assisted minimally invasive repair,CAMIR)治疗急性跟腱断裂中,保护套筒与腓肠神经的位置关系。方法选取12具成年尸体下肢标本,左侧6具、右侧6具。在小腿标本近端距离跟腱止点4 cm处置入CAMIR跟腱吻合器,沿跟腱内侧纵形切开皮肤,游离腓肠神经,观察保护套筒与腓肠神经的位置关系,使用游标卡尺分别测量腓肠神经与跟腱外侧缘交点至跟骨止点距离、保护套筒与跟骨止点垂直距离、腓肠神经与保护套筒水平距离。结果解剖可见腓肠神经与保护套筒空间位置关系不固定,腓肠神经位于保护套筒上方(8具)或下方(4具)。整个缝合过程均在保护套筒内进行,12具标本均未发生腓肠神经损伤。测量示腓肠神经与跟腱外侧缘交点至跟骨止点距离为(105.67±14.94)mm,保护套筒与跟骨止点垂直距离为(93.20±9.57)mm,腓肠神经与保护套筒水平距离为(0.31±0.14)mm。结论采用CAMIR治疗急性跟腱断裂,可以有效避免腓肠神经损伤。Objective To evaluate the positional relationship between protective channel and sural nerve while treating acute Achilles tendon rupture with channel assisted minimally invasive repair(CAMIR)technique based on anatomical observations of cadaver specimens.Methods Twelve adult cadaveric lower limb specimens(6 left,6 right)were utilized.A CAMIR device was implanted at a distance of 4 cm from the proximal end of the specimen to the Achilles tendon insertion.The skin was incised along the tendon’s medial side,the sural nerve was dissected,and the positional relationship with the protective channel was observed.The distance from the sural nerve-Achilles tendon intersection to the calcaneal insertion,the vertical distance between protective channel and the calcaneal insertion,and the horizontal distance between the sural nerve and protective channel were measured by using vernier caliper.Results Anatomical examination demonstrated a variable positional relationship between the sural nerve and protective channel,with the sural nerve positioned above(8 specimens)or below(4 specimens)the protective channel.The distance from the sural nerve-Achilles tendon intersection to the calcaneal insertion was(105.67±14.94)mm,the vertical distance between protective channel and the calcaneal insertion was(93.20±9.57)mm,and the horizontal distance between the sural nerve and protective channel was(0.31±0.14)mm.Conclusion The use of CAMIR technique for the treatment of acute Achilles tendon rupture can effectively avoid iatrogenic injury to the sural nerve.

关 键 词：急性跟腱断裂 通道辅助微创吻合技术 腓肠神经损伤 尸体研究 

分 类 号：R687.2[医药卫生—骨科学] R322[医药卫生—外科学]