Kirgis A, Albrecht S
Department of Anatomy, Ev. Waldkrankenhaus Spandau, Teaching Hospital, Free University of Berlin--Medical School, Federal Republic of Germany.
J Bone Joint Surg Am. 1992 Sep;74(8):1180-5.
Iatrogenic, isolated weakness or paralysis of the extensor hallucis longus muscle is a common complication in patients who have had a proximal tibial and fibular osteotomy. To investigate why this complication occurs, we dissected the deep peroneal nerve and neighboring structures, such as the tibia and fibula and the muscles of the leg, in twenty-nine specimens from cadavera, paying special attention to the motor branches supplying the extensor hallucis longus. Of forty-six motor nerves that were identified, eight entered the muscle from the lateral side in an area seventy to 150 millimeters distal to the fibular head; all of them ran close to the fibular periosteum. We suggest that, in some patients, the nerve supply to the extensor hallucis longus is at high risk for injury during a tibial osteotomy because of the proximity of the bone to the motor branches.
医源性孤立性拇长伸肌无力或麻痹是胫腓骨近端截骨术患者的常见并发症。为了探究该并发症发生的原因，我们对29具尸体标本的腓深神经及邻近结构（如胫腓骨和小腿肌肉）进行了解剖，特别关注供应拇长伸肌的运动分支。在识别出的46条运动神经中，有8条在距腓骨头远端70至150毫米的区域从外侧进入该肌肉；它们均紧贴腓骨骨膜走行。我们认为，在一些患者中，由于骨与运动分支距离较近，在胫骨截骨术期间，拇长伸肌的神经供应有受伤的高风险。
