腓总神经与胫神经外侧头肌支解剖关系 在小腿瘦形术中的应用指导

Anatomical characteristic of common peroneal nerve and lateral dorsal muscle of tibial nerve in application of calf surgery

摘要:

目的 研究腓总神经与胫神经外侧头肌支解剖关系在小腿瘦形术中的应用指导。方法 选取14 例女 性及2 例男性防腐标本共32 侧小腿作研究对象。分别将将防腐标本股骨内外上髁连线设为X 轴，垂直于股骨 内外上髁连线且过中点的虚拟线设为Y 轴，建立防腐标本小腿二维坐标系，从腘窝入路逐层解剖，追踪腓总神 经与胫神经腓肠肌外侧头肌支，将胫神经腓肠肌外侧头肌支走行映射到防腐标本小腿二维坐标系中，记录相关 数据。结果 腓总神经由坐骨神经股骨内外上髁连线上方11.61 cm 处以（21.36±3.41）°角向下发出；腓肠肌 外侧头肌支由胫神经股骨内外上髁连线上方4.04cm 以（28.63±2.87）°角向下发出。腓肠肌外侧头肌支起点距 腓总神经（2.64±0.87）cm，两者在股骨内外上髁水平相距（2.89±0.68）cm。结论 腓总神经与胫神经腓肠外 侧头肌支在腘窝的解剖位置相距较近。小腿瘦形术中进行与腓肠肌外侧头肌支相关的操作，勿伤及腓总神经。

Abstract:

Objective To investigate anatomical characteristic of common peroneal nerve and medial tibial nerve and its application in calf transplants. Methods Fourteen female and 2 male anti-corrosion specimens as a total of 32 calves were involved in this study. Connection of femoral internal and external condyle stood for X axis and Y axis stood at midpoint of connection of femoral internal and external condyle, perpendicular to X axis. For establishment of anti-corrosion specimen calf two-dimensional coordinate system. The anatomical position of the common nerve, medial branch of the tibial nerve of the tibial nerve and the lateral dorsal muscle of the tibial nerve were mapped to the two-dimensional coordinate system. Results The common peroneal nerve was emitted from the upper and lower condyles of the sciatic nerve at the angle of 11.61 cm (21.36 ± 3.41). The gastrocnemius muscle of the gastrocnemius muscle started downwards with the angle of (28.63 ± 2.87) at 4.04 cm above the internal and external epicondyle of the tibial nerve. Distance between origin of external epicondyle of the tibial nerve and common peroneal nerve was (2.64 ± 0.87) cm, and that was (2.89 ± 0.68) cm at the level of the medial and lateral condyles of femur. Conclusion Common peroneal nerve stands close to the tibial nerve epicardial lateral branch muscle in the popliteal fossa; extra caution should be paid when performing calf thin surgery, avoidinginjury of the common peroneal nerve.