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胫骨神经分支模式和腓深神经分支的兼容性。

Tibial nerve branching pattern and compatibility of branches for the deep fibular nerve.

机构信息

School of Medicine, Department of Anatomy, Ankara University, Sihhiye, Ankara, 06100, Turkey.

Gulhane Faculty of Medicine, Department of Anatomy, University of Health Sciences Turkey, Ankara, Turkey.

出版信息

Surg Radiol Anat. 2024 Apr;46(4):413-424. doi: 10.1007/s00276-024-03329-6. Epub 2024 Mar 13.

Abstract

PURPOSE

In individuals who develop drop foot due to nerve loss, several methods such as foot-leg orthosis, tendon transfer, and nerve grafting are used. Nerve transfer, on the other hand, has been explored in recent years. The purpose of this study was to look at the tibial nerve's branching pattern and the features of its branches in order to determine the suitability of the tibial nerve motor branches, particularly the plantaris muscle motor nerve, for deep fibular nerve transfer.

METHODS

There were 36 fixed cadavers used. Tibial nerve motor branches were observed and measured, as were the lengths, distributions, and thicknesses of the common fibular nerve and its branches at the bifurcation region.

RESULT

The motor branches of the tibial nerve that supply the soleus muscle, lateral head, and medial head of the gastrocnemius were studied, and three distinct forms of distribution were discovered. The motor branch of the gastrocnemius medial head was commonly observed as the first branch to divide, and it appeared as a single root. The nerve of the plantaris muscle was shown to be split from many origins. When the thickness and length of the motor branches measured were compared, the nerve of the soleus muscle was determined to be the most physically suited for neurotization.

CONCLUSION

In today drop foot is very common. Traditional methods of treatment are insufficient. Nerve transfer is viewed as an application that can both improve patient outcomes and hasten the patient's return to society. The nerve of the soleus muscle was shown to be the best candidate for transfer in our investigation.

摘要

目的

在因神经损伤而导致足下垂的个体中,通常采用脚腿矫形器、肌腱转移和神经移植等几种方法。近年来,神经移植也得到了探索。本研究旨在观察胫神经的分支模式及其分支特征,以确定胫神经运动支,特别是比目鱼肌运动神经,是否适合腓深神经转移。

方法

使用 36 具固定尸体。观察和测量胫神经运动支以及在分叉区腓总神经及其分支的长度、分布和厚度。

结果

研究了支配比目鱼肌、腓肠肌外侧头和内侧头的胫神经运动支,发现了三种不同的分布形式。腓肠肌内侧头的运动支通常是第一个分支,呈单根。比目鱼肌的神经显示是从多个起源处分裂而来。当比较测量的运动支的厚度和长度时,发现比目鱼肌的神经最适合神经化。

结论

在当今社会,足下垂非常普遍。传统的治疗方法是不够的。神经移植被视为一种既能改善患者预后又能加速患者回归社会的应用。在我们的研究中,比目鱼肌的神经被证明是最适合转移的神经。

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