腓浅神经的行程与腓骨骨折的手术入路

The location of the superficial peroneal nerve in the leg and its relation to the surgical approach of the fibula

目的:体表定位腓浅神经,为腓骨骨折提供安全合适的手术入路。方法:经4%甲醛溶液固定的成人尸体下肢标本66例,男42例,女24例;年龄37～88岁,平均69岁;左侧35例,右侧31例。对下肢的腓浅神经进行解剖,观察测量腓浅神经在小腿各部位的行走、分支情况及与体表标志的关系。结果:腓浅神经于腓骨颈的前外侧离开腓总神经,旁开腓骨头与外踝连线稍前方,下行于肌内、深筋膜下和浅筋膜内;主干12例在小腿以单支向下至足背,50例在穿出深筋膜于浅筋膜内分为2支,4例穿出肌肉后即分为2支。结论:为了避免损伤腓浅神经,腓骨中上段骨折宜从腓侧后肌间隙入路,腓骨下段骨折宜从腓侧前肌间隙入路。目的:体表定位腓浅神经,为腓骨骨折提供安全合适的手术入路。方法:经4%甲醛溶液固定的成人尸体下肢标本66例,男42例,女24例;年龄37～88岁,平均69岁;左侧35例,右侧31例。对下肢的腓浅神经进行解剖,观察测量腓浅神经在小腿各部位的行走、分支情况及与体表标志的关系。结果:腓浅神经于腓骨颈的前外侧离开腓总神经,旁开腓骨头与外踝连线稍前方,下行于肌内、深筋膜下和浅筋膜内;主干12例在小腿以单支向下至足背,50例在穿出深筋膜于浅筋膜内分为2支,4例穿出肌肉后即分为2支。结论:为了避免损伤腓浅神经,腓骨中上段骨折宜从腓侧后肌间隙入路,腓骨下段骨折宜从腓侧前肌间隙入路。

Objective ：To localize the superficial peroneal nerve in surface of the leg and to provide a safety surgical approach to the fibula. Methods：Sixty-six adult legs preserved by 4% formaldehyde solution were studied involving 42 male and 24 female with the average age of 69 years old ranging from 37 to 88 years. There were 35 cases in left and 31 in right. According to the common lateral surgical approach to the fibula,the superficial peroneal nerve and its branches were dissected in 66 embalmed leg-ankle-foot specimens. The specimens were observed and measured. Results ：The superficial peroneal nerve branched from the common peroneal nerve near the anterolateral aspect of the neck of the fibula, transversing through the muscle, deep fascia and superficial fascia. In 12 cases of specimens, superficial fibular nerve extended to the foot with no branches, in 50 cases of specimens, it branched out into two before piercing the deep fascia, in the rest 4 cases of specimens,it branched out into two before piercing the muscle. Conclusion：To avoid injuring the superficial peroneal nerve, the surgical approach to the 2/3 upper part of the fibula is at posterior crural septum,to the 1/3 lower part of the fibula is at anterior crural septum.