Wang Zhonghe, Cao Wenhao, Qi Hongzhe, Kong Lingtong, Liu Haoyu, Chen Chen, Li Lianhua, Sun Lijun, Chen Hua
Graduate School, Ningxia Medical University, Yinchuan Ningxia, 750004, P. R. China.
Orthopedic Department Unit 1, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024 Nov 15;38(11):1325-1329. doi: 10.7507/1002-1892.202408055.
To evaluate the positional relationship between protective channel and sural nerve while treating acute Achilles tendon rupture with channel assisted minimally invasive repair (CAMIR) technique based on anatomical observations of cadaver specimens.
Twelve adult cadaveric lower limb specimens (6 left, 6 right) were utilized. A CAMIR device was implanted at a distance of 4 cm from the proximal end of the specimen to the Achilles tendon insertion. The skin was incised along the tendon's medial side, the sural nerve was dissected, and the positional relationship with the protective channel was observed. The distance from the sural nerve-Achilles tendon intersection to the calcaneal insertion, the vertical distance between protective channel and the calcaneal insertion, and the horizontal distance between the sural nerve and protective channel were measured by using vernier caliper.
Anatomical examination demonstrated a variable positional relationship between the sural nerve and protective channel, with the sural nerve positioned above (8 specimens) or below (4 specimens) the protective channel. The distance from the sural nerve-Achilles tendon intersection to the calcaneal insertion was (105.67±14.94) mm, the vertical distance between protective channel and the calcaneal insertion was (93.20±9.57) mm, and the horizontal distance between the sural nerve and protective channel was (0.31±0.14) mm.
The use of CAMIR technique for the treatment of acute Achilles tendon rupture can effectively avoid iatrogenic injury to the sural nerve.
基于尸体标本的解剖学观察，评估采用通道辅助微创修复（CAMIR）技术治疗急性跟腱断裂时保护通道与腓肠神经之间的位置关系。
使用12例成人尸体下肢标本（6左，6右）。将CAMIR装置从标本近端向跟腱止点处4 cm的距离植入。沿肌腱内侧切开皮肤，解剖腓肠神经，观察其与保护通道的位置关系。使用游标卡尺测量腓肠神经-跟腱交点至跟骨止点的距离、保护通道与跟骨止点的垂直距离以及腓肠神经与保护通道的水平距离。
解剖检查显示腓肠神经与保护通道之间的位置关系存在差异，腓肠神经位于保护通道上方的有8例标本，位于下方的有4例标本。腓肠神经-跟腱交点至跟骨止点的距离为（105.67±14.94）mm，保护通道与跟骨止点的垂直距离为（93.20±9.57）mm，腓肠神经与保护通道的水平距离为（0.31±0.14）mm。
采用CAMIR技术治疗急性跟腱断裂可有效避免医源性腓肠神经损伤。
