Fernández Á, Poggio D, Llusá M, Álvarez C, Cufí Prat M
Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínic de Barcelona, Barcelona, Spain.
Departamento de Anatomía Humana y Embriología, Facultad de Medicina, Universidad de Barcelona, Barcelona, Spain; Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínic, Barcelona, Spain.
Rev Esp Cir Ortop Traumatol. 2022 Sep-Oct;66(5):T341-T347. doi: 10.1016/j.recot.2022.07.003. Epub 2022 Jul 14.
The vascular anatomy of the talus attracts intense research being not always easy to understand. The high intraosseous variability together with the anatomical characteristics makes some areas of the talus more prone to vascular compromise. The aim of this study is to describe the vascularisation of the talus, both intraosseous and extraosseous.
From the literature reviewed, we have developed a graphic scheme that allows easy observation of the irrigation distribution. To this end, nineteen anatomical dissections of human cadaveric feet have been carried out. Fifteen fresh-frozen slices have been cut in different planes and prepared using the modified Spalteholz technique and latex injection with blue and black ink to visualise the vascular network. In addition, the study has been complemented with a comprehensive literature review on this subject.
The findings allowed us to conclude that the posterior tibial artery provides the most important blood supply to the neck and body of the talus through the tarsal canal artery and the deltoid branch. The anterior tibial artery splits in the dorsal pedis artery, for the head and neck, and the lateral tarsal artery which throughout anastomoses breeds the tarsal sinus artery. The perforating peroneal artery branches out from the peroneal artery, creating an intraosseous anastomosis for the body and the posterior process.
The results obtained have contributed to develop a graphical representation that we present in this study, which allows a simple understanding of the intraosseus and extraosseus vascularisation of the talus.
距骨的血管解剖结构吸引了大量研究，因其并不总是易于理解。骨内高度的变异性以及解剖学特征使得距骨的某些区域更容易出现血管受损情况。本研究的目的是描述距骨的骨内和骨外血管分布情况。
通过对文献的综述，我们绘制了一个图表，便于观察血供分布。为此，我们对19具人类尸体足部进行了解剖。在不同平面切取了15片新鲜冷冻切片，并采用改良的斯帕尔采尔兹技术和注入蓝色和黑色墨水的乳胶进行处理，以显示血管网络。此外，本研究还辅以关于该主题的全面文献综述。
研究结果使我们得出结论，胫后动脉通过跗管动脉和三角支为距骨的颈部和体部提供最重要的血液供应。胫前动脉在足背动脉处分支，为距骨头和颈部供血，而外侧跗动脉全程与跗窦动脉吻合。腓骨穿支动脉从腓动脉分出，为距骨体和后突形成骨内吻合。
本研究所得结果有助于绘制出我们在此展示的图表，该图表能让人简单了解距骨骨内和骨外的血管分布情况。
