股骨前肌腱止点的解剖研究在马蹄足手术中的应用

Anatomical Research of the Anterior Tibial Tendon and It's Application in the Operation of the Equinovarus.

目的 :观察国人胫骨前肌腱止点的形态 ,附丽部位范围以及变异情况 ,为胫骨前肌外移矫正马蹄内翻足的手术提供一些解剖学依据。方法 :本研究选择了 2 2例国人踝关节防腐足标本 ,进行胫骨肌腱止点解剖学和组织切片观察 ,并进行分类 ;记录了胫骨前肌腱以内侧楔骨或第一跖骨为主要止点的各自数目。结果 :可分为三型 ,分别为 :Ⅰ型 :束状型 1 4侧 ,占总数 63 . 6 % ;Ⅱ型 :中间型共 6侧 ,占总数 2 7. 3 % ;Ⅲ型 :分叉型共 2侧 ,占总数 9. 1 % ;胫骨前肌腱止点以第一跖骨为主 3侧 ,占总数 1 3 . 6 % ;胫骨前肌腱止点以内侧楔骨为主 1 3侧 ,占总数 86 . 4 %。结论 :束状型胫骨前肌腱不适于作半腱外移植手术矫正马蹄内翻足 ;中间型胫骨前肌腱适于作半腱外移植术矫正马蹄内翻足 ;分叉型胫骨前肌腱除作以内侧楔骨为主的横切口外 。

Objective: To give some knowledge of the Equinovarus operation,the insertion of the anteior tibial tendon were observed. Methods:The proportion of the tendon's insertion on the first metatrsal os and the mediale cuneiform os were observed in 22 feet of Chinese cadaver using the naked-eye and histology. Results:The insertions of the anterior tibial tendon has three types :the type Ⅰ,Ⅱ,Ⅲ. The insertions on the first metatarsal os and the mediale cuneiform os take the 13.6 percentage and 86.4 percentage of the total numbers respectively. Conclusions:The typeⅠ is not suitable for operation of the anterior tibial tendon transfer. The type Ⅱ is suitable for this operation. The orthopeadist can make the perpendicular incision at the distal part of the mediale cuneiform os and the transvers incision on the inside of the mediale cuneiform os in type Ⅲ .