拇外翻截骨术中第一跖骨营养动脉的位置及危险方向。
Location and direction of the nutrient artery to the first metatarsal at risk in osteotomy for hallux valgus.
作者信息
Tonogai Ichiro, Wada Keizo, Higashino Kosaku, Fukui Yoshihiro, Sairyo Koichi
机构信息
Department of Orthopedics, Institute of Biomedical Science, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
Department of Anatomy and Developmental Neurobiology, Tokushima University Graduate School, Japan.
出版信息
Foot Ankle Surg. 2018 Oct;24(5):460-465. doi: 10.1016/j.fas.2017.05.004. Epub 2017 Jun 2.
BACKGROUND
Osteotomy for hallux valgus interrupts intraosseous blood supply to the first metatarsal, presumably causing non-union, delayed union, or osteonecrosis of the head of the first metatarsal. We investigated the first metatarsal nutrient artery, arising from the first dorsal metatarsal artery, and identified aspects of surgical technique contributing to nutrient artery injury.
METHODS
Enhanced computed tomography scans of 8 feet of 8 fresh cadavers were assessed. Barium was injected through the external iliac artery; location and direction of the first metatarsal nutrient artery was recorded.
RESULTS
Mostly, the nutrient artery entered the first metatarsal at the distal third or junction of the middle and distal thirds obliquely from a proximal direction coronally; entry point and direction varied axially. Saw blade overpenetration alone or with extensive capsular stripping might damage the artery.
CONCLUSIONS
Location and direction of the first metatarsal nutrient artery was established.
背景
拇外翻截骨术会中断第一跖骨的骨内血供，可能导致第一跖骨头不愈合、延迟愈合或骨坏死。我们研究了起自第一跖背动脉的第一跖骨滋养动脉，并确定了导致滋养动脉损伤的手术技术方面的问题。
方法
对8具新鲜尸体的8只脚进行增强计算机断层扫描评估。通过髂外动脉注入钡剂；记录第一跖骨滋养动脉的位置和方向。
结果
大多数情况下，滋养动脉从近端向冠状面斜行进入第一跖骨的远端三分之一处或中、远端三分之一交界处；进入点和方向在轴向上有所不同。仅锯片过度穿透或伴有广泛的关节囊剥离可能会损伤该动脉。
结论
确定了第一跖骨滋养动脉的位置和方向。
Zotero 插件