胫骨前肌腱及其止点的应用解剖研究  

Study on Anatomy of Anterior Tibial Tendon and Its Clinical Application

作　　者：王林强[1] 彭明惺[1] 刘蜀生[2] 朱磊[2] 靳升荣[2] 刘利君[1] 刘敏[1] 张敬东[1] 

机构地区：[1]四川大学华西医院小儿外科,成都610041 [2]四川大学华西基础医学与法医学院人体解剖学教研室

出　　处：《四川大学学报（医学版）》2003年第1期58-60,共3页Journal of Sichuan University(Medical Sciences)

摘　　要：目的　观察国人胫骨前肌腱止点的形态 ,附着部位以及变异情况 ,为临床应用提供解剖学依据。方法　选择 4 6侧国人灌注后防腐足标本 ,作胫骨前肌腱止点解剖学观察 ,组织学观察 ,记录胫骨前肌腱以内侧楔骨或第一跖骨为主要止点各自的数据 ,测量胫骨前肌腱内外踝突连线平面以下长度。结果　根据胫骨前肌腱止点的形态可分为三型 :束状型 2 8侧 (6 0 .87% ) ;中间型 14侧 (30 .4 3% ) ;分叉型 4侧 (8.7% )。胫骨前肌腱止点以内侧楔骨或第一跖骨为主分别为 4 0侧 (86 .96 % )和 6侧 (13.0 4 % )。成尸足及童尸足于内外踝突连线平面以下胫骨前肌腱的长度分别为 72 .33± 5 .2 9m m和 5 6 .77± 4 .5 4 mm。结论　若作胫骨前肌腱向外移植术时 ,注意将分叉型的变异止点完全切断。束状型和分叉型胫骨前肌腱不宜作半腱外移植术 ;Objective To observe the normal and abnormal insertions of the anterior tibial tendon and store up knowledge for clinical application. Methods Forty six antiseptic specimens of the foot of Chinese were selected for anatomical and histological studies on the insertions. The methods included taking the photos, adding up the numbers of the insertions that mainly attach to the first metatarsal os or the medial cuneiform os and measuring the length of the tendons from the line connecting the malleolus lateralis projection and malleolus medialis projection to the insertion. Results The insertions could be categorized as three types: 28(60.87%) insertions belonged to the bundle type; 14(30.43%)insertions were of the medial type; 4(8.7%) insertions were of the bifurcate type. 40 insertions mainly attached to the medial cuneiform os; 6 insertions mainly attached to the first metatarsal os. The length of the anterior tibial tendon of adults was determined to be 72.33±5.29mm and the length of the children's tendon 56.77±4.54mm. Conclusion The aboved finding suggest that in clinical treatment the insertions of the bifurcate type should be cut off completely as the anterior tibial tendons of the bifurcate type are transferred into the lateral part of the feet. The insertions of the bundle type and bifurcate type are not suitable for the split anterior tibial tendon transfer, but the medial type cases are suitable for this kind of operation.

关 键 词：胫骨前肌腱止点 马蹄内翻足 钩状足 

分 类 号：R323.72[医药卫生—人体解剖和组织胚胎学]