胫骨上干骺端一骨干截骨延长术的应用解剖

Applied anatomy of proximal metaphyseal─diaphyseal osteotomy in tib-ia lengthening

在３０侧成人下肢标本上，解剖观测了胫腓骨上端的肌肉、韧带附着，血管、神经穿经部位以及胫腓关节。结果表明：胫骨上于骺端一骨干截骨延长术能将膝关节伸屈肌止点和膝关节韧带附着保留于截骨近瑞，维持术后膝关节及截骨端的稳定和运动时的受力均衡，术式设计符合生物力学原理，对血供干扰少。文中讨论了手术设计的解剖学依据及手术的应用要点。

iu FanggangDepartment of Orthopaedics,The 359th Hospital of PLA,Zhenjiang The attachments of muscles and ligaments on the proximal parts of tibia and fibula,thestructure of superior tibiofibular articulation,he interosseous membrane and the pathways ofmain blood vessels and nerves in the region,were observed and measured on 30 sides of strippedaqdult cadaveric lower extremities. The results show that the attachments of the extensor andflexor muscles and the collateral ligaments of the knee joint can be reserved in the proximal meta-physeal─diaphyseal osteotomy,to maintain the stability of the knee. The design of proximalmetaphyseal ─diaphyseal osteotomy is in accordance with biomechanical principles.Key pointsfor operative technique are discussed.