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目的为胫骨近端骨折“T”入路术式提供解剖学基础。方法 (1)灌注红色乳胶于4例成人下肢标本,对胫骨上段的血供和神经的分布进行研究,另在4例标本上摹拟手术。结果 (1)胫骨上段血供由骨骺干骺血管、滋养血管和骨膜血管系统构成;小腿上段神经由隐神经髌下支和胫前返神经分支分布;(2)“T”入路术式仅见膝降动脉的髌下支断裂,未见明显的神经分支,各层组织均有大量红色塑料溢出,切口均能充分暴露胫骨近端及关节面。结论 (1)胫骨上段和切口周围血供丰富;(2“)T”入路术式对胫骨近段血运和神经无影响,且骨折端暴露充分、直视下手术操作安全方便。
Objective To provide anatomic basis for proximal tibial fracture “T” approach. Methods (1) Infusion of red latex in 4 cases of adult lower extremity specimens, the upper tibia of blood supply and nerve distribution, and the other in 4 cases simulated surgery. Results (1) The upper tibia blood supply by epiphyseal metaphyseal vessels, nourishing blood vessels and the periosteum vascular system; the upper leg of the saphenous nerve by the saphenous nerve and the anterior patellar branch of the branch; (2) “T ” approach Only the knee-type knee inferior patellar retinaculum rupture, no obvious nerve branches, each layer has a large number of red plastic overflow, the incision can fully expose the proximal tibia and articular surface. Conclusions (1) The blood supply is abundant in the upper tibia and the incision; (2) T "approach has no effect on the blood supply and nerve in the proximal tibia, and the fracture end is well exposed. The operation is safe and convenient under direct vision.