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目的观察小腿段胫神经束组及其血供,为小腿段胫神经损伤修复或游离移植提供解剖学依据。方法①成人小腿标本26侧,分离胫神经主干及主要肌支,观察和测定各支横径、长度、起始位置、神经束无损伤分离长度。②4侧新鲜成人小腿标本分别行动脉乳胶及墨汁灌注并制作透明标本,观察胫神经营养动脉。③4侧新鲜成人小腿标本上,死亡4 h内取下胫神经及分支并行胆碱酯酶染色,观察胫神经感觉束、运动束分布。结果胫神经主要肌支均在小腿8/8~6/8段分出,5/8~1/8段无重要肌支发出;胫神经干中内侧束组、外侧束组自然分束的距离长,平均为(361.4±7.1)mm;胫神经营养动脉丰富,胫后动脉与胫神经全程伴行,为其主要营养动脉;7/8~5/8段主要来自腓动脉,5/8~1/8段主要来自胫后动脉;胫神经内、外侧束组有相对独立的、完善的血供系统。结论胫神经上述解剖学特点为小腿部胫神经损伤的修复提供一定解剖学依据。小腿5/8~1/8段胫神经束组具有独立和完善血供系统,内外侧束组无损伤分离长度长,具备了带血供游离移植的供体神经解剖学特点。
Objective To observe the tibial nerve bundle group and its blood supply in the lower leg and to provide anatomic evidence for the repair or free transplantation of the tibial nerve in the lower leg. Methods ①At the 26th side of the adult calf, the main trunk of the tibial nerve and its major muscular branches were isolated and the length of the branch, length, initial position, and the length of the non-injured nerve bundle were observed and measured. ② fresh adult calf on the 4 sides of the arteries were injected with arterial latex and ink, respectively, and made transparent specimens to observe the tibial nerve nutrition artery. ③ fresh adult calf on the 4 side of the specimen, within 4 h after death removed the tibial nerve and branch parallel cholinesterase staining, tibial nerve sensory tract, exercise beam distribution. Results The major branches of the tibial nerve were separated in the 8/8 to 6/8 legs and no significant musculature occurred in the 5/8 to 1/8 segments. The distance between the medial bundle and the lateral bundle in the tibial nerve trunk (361.4 ± 7.1) mm, the trophic trophic arteries were abundant, and the tibial nerve was accompanied with the tibial nerve throughout the course of the trophic artery. The main trophic arteries were from 7/8 to 5/8, 1/8 segment mainly from the posterior tibial artery; tibial nerve inside and outside the beam group has a relatively independent, complete blood supply system. Conclusion The anatomical features of the tibial nerve provide an anatomical basis for the repair of tibial nerve injury in the lower leg. The tibial nerve bundle group of leg from 5/8 to 1/8 leg had independent and perfect blood supply system, and the length of separation was longer without injury in the lateral and lateral bundle groups, which possessed the characteristics of donor neuroanatomy with blood supply for free transplantation.