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目的探讨吻合神经血管的趾短伸肌游离移植重建臂丛根性损伤后手内肌功能的相关解剖学基础。方法利用经甲醛防腐固定成人尸体下肢标本30侧,显露腓深神经沿其走行追踪腓深神经趾短伸肌肌支,显微解剖分离趾短伸肌,观察趾短伸肌肌肉形态、主要血供来源及主要支配神经走行,测量趾短伸肌的长度、宽度、厚度及腓深神经、趾短伸肌肌支的直径和最大可逆行分离长度。结果短伸肌有一个相对独立的肌腹和一条肌腱,趾短伸肌有一个共同的肌腹,3条肌腱,也有4腱发出其中3腱型占80%,4腱型占20%。趾短伸肌长度为(6.15±0.40)cm,宽度为(3.85±0.04)cm,厚度为(0.21±0.02)cm,其主要血供来自足背动脉,受腓深神经的趾短伸肌肌支支配,后者在腓深神经可主干中逆行分离的最大长度为(27.41±2.54)cm。结论趾短伸肌为羽状肌,有独立、恒定的血管、神经支配,且神经逆行分离长度较长,适合行利用吻合血管神经的趾短伸肌移植以重建臂丛根性损伤后手内在肌功能。
Objective To investigate the anatomical basis of the function of intramuscular muscles after brachial plexus root injury with free grafting of the extensor digitorum longus muscle in conformity with neural blood vessels. Methods The corpse of the lower extremity of the deep peroneal nerve was observed by the peroneal nerve along the 30 sides of the lower extremity specimens of adult cadavers preserved by formaldehyde. The muscular branches of the extensor digitorum longus muscle were dissected microscopically. For the source and the main dominant nerve, the length, width and thickness of the extensor digitorum longus and the deep peroneal nerve, the diameter of the muscular branch of the extensor digitorum brevis and the maximum reversible separation length were measured. Results The short extensor had a relatively independent muscle belly and a tendon. The extensor digitorum had a common muscle belly, three tendons, and four tendons. Three tendons accounted for 80% and four tendons accounted for 20%. The length of the extensor digitorum longus was (6.15 ± 0.40) cm, the width was (3.85 ± 0.04) cm and the thickness was (0.21 ± 0.02) cm. The main blood supply was from the dorsalis pedis artery, The maximum length of retrograde separation of the latter in the trunk of the peroneal nerve was (27.41 ± 2.54) cm. Conclusions: The extensor digitorum longus is a feather muscle with independent and constant blood vessels and innervation. The length of retrograde nerve separation is longer, which is suitable for the reconstruction of the endometriosis after brachial plexus rhizotomy Features.