股骨髓内钉进针点对股骨近端血供影响的解剖学研究

The effects of entry points of femoral intramedullary nail on the blood supply of proximal femur:anatomic study

目的推导股骨髓内钉进针点对股骨近端血供的影响。方法正常成人防腐髋关节标本68侧,观测旋骨外侧动脉、旋骨内侧动脉、臀上动脉和臀上动脉在股骨近端的分布、位置及与肌肉的关系,以及在股骨近端的血管吻合情况。结果 10.3%(7侧)在臀小肌附着处旋股外侧动脉升支与旋股内侧动脉深支吻合,89.7%(61侧)旋股内侧动脉深支与臀下动脉相吻合,70.6%(48侧)旋股内侧动脉深支与臀上动脉相吻合。结论当旋股内侧动脉损伤时其血供可由臀上、臀下动脉吻合补偿,而并非为旋股外侧动脉代偿。

Objeotive To explore the blood supply damage around the proximal femur during the process of femoral intramedullary nailing. Methods The study was performed on 68 adult antiseptic hip joint specimens. The distribution and location of medial femoral circumflex artery （MFCA）, lateral femoral circumflex artery （LFCA）, superior gluteal artery（SGA）, inferior gluteal artery（IGA）, and their relationship with adjacent muscles were exposed, as well, their anastomosis around proximal femur were measured. Results Anastomosis between LFCA＇s descending branch and MFCA＇s deep branch appeared in 7 cases （10.3%）, and anastomosis between MFCA＇s deep branch and IGA in 61 cases （89.7%）, anastomosis between MFCA＇s deep branch and SGA in 48 cases （70.6%）. Conclusions Instead of LFCA, the deep branch of MFCA may be capable of being compensated by IGA and SGA together.