内镜治疗踝管综合征的解剖学研究

Endoscopic study and evaluation of anatomy related tarsal tunnel syndrome

目的研究内镜下踝管的相关解剖、毗邻和手术入路及其在手术中的意义。方法大体解剖5具尸体(10侧)和内镜下松解胫神经及内外侧管之间纤维10具(20侧)。结果结合大体解剖测得数据确定内镜解剖踝管的手术学入路(采取三点入路:内踝尖和跟腱止点内侧缘连线中点垂线上4.5 cm;内踝尖和跟骨结节连线中点;跟骨结节和第一跖趾关节内侧缘连线中点),并成功根据入路进行内镜下松解胫神经和内外侧管之间的纤维隔。结论根据解剖数据设计手术入路解决利用内镜探查弯曲管道的可行性。

Objective To explore the anatomy and the adjacent of the medial malleolus, the operative approach of soluting the tibial nerve in endoscopy and the significance of making use of it in operation. Methods The five cadaver feet were dissected, the tibial nerve and the fiber diaphragm in the middle of medial and lateral plantar tunnels in the ten cadaver feet were soluted in endoscopic. Results The operative approach was designed on the basis of the anatomy data （ the three-portal approach ： The perpendicular bisctor which was the medial malleolus pointed to the medial margin of tendon calcaneus insertion was 4. 5cm; The midpoint of the medial malleolus pointed to the calcaneus tubercle ; The midpoint of the calcaneus tubercle to the medial margin of the first metatarsophalangeal joint）. It was succeed that soluted the tibial nerve and the fiber diaphragm in the middle of medial and lateral plantar tunnels. Conclusion The operative approach on the basis of the anatomy data is design, and testfy the feasibility of exploring curved tunnel in endoscopic.