Ebraheim N A, Lu J, Hao Y, Biyani A, Yeasting R A
Department of Orthopaedic Surgery, Medical College of Ohio, Toledo 43614, USA.
Surg Radiol Anat. 1998;20(4):259-62. doi: 10.1007/BF01628486.
The anterior tibial artery (ATA) is at risk of injury during high tibial osteotomy, Ilizarov wire placement, pin placement in external fixation, or proximal locking screw insertion, as the artery is not visualized intraoperatively. The ATA is anchored to the oval foramen of the interosseous membrane on the proximal tibia by the deep fascia and recurrent genicular vascular branches. Segment 1 (from the bifurcation of the popliteal artery to the level of the interosseous foramen) and the proximal part of segment 2 (from the interosseous foramen to the level where the artery crosses the anterior border of the tibia) may be damaged when pin, wire or screw placement is directed posterolaterally at that level. Distally, a straight mediolateral pin or Ilizarov wires may lacerate the artery. Segment 2 of the ATA descends against the interosseous membrane in its proximal part, which is projected on the posterior third of the tibia relative to the sagittal plane; in its middle part, it runs close to the lateral cortex of the tibia, it is projected on the middle third of the tibia; in its distal part it runs gradually towards the anterior third of the tibia and contacts with the anterior third of the tibial cortical surface. This information may help reduce risk of injury to the ATA during high tibial osteotomy, external fixation and pin placement or insertion of locking screws.
胫骨前动脉（ATA）在高位胫骨截骨术、伊里扎洛夫钢丝置入、外固定器钢针置入或近端锁定螺钉插入过程中存在损伤风险，因为术中无法看到该动脉。ATA通过深筋膜和膝返血管分支固定于胫骨近端骨间膜的卵圆孔。当在该水平向后外侧置入钢针、钢丝或螺钉时，第1段（从腘动脉分叉处至骨间孔水平）和第2段的近端部分（从骨间孔至动脉穿过胫骨前缘的水平）可能会受损。在远端，一枚直的内外侧钢针或伊里扎洛夫钢丝可能会划破动脉。ATA第2段在其近端部分贴着骨间膜下行，相对于矢状面，该段投影于胫骨后三分之一处；在其中部，它靠近胫骨外侧皮质走行，投影于胫骨中三分之一处；在其远端，它逐渐向胫骨前三分之一处走行，并与胫骨皮质表面的前三分之一接触。这些信息可能有助于降低高位胫骨截骨术、外固定以及钢针置入或锁定螺钉插入过程中ATA的损伤风险。
