距骨颈骨折闭合复位后路螺钉固定的应用解剖学分析.doc

心的连线的中点为体表进针点，以垂直此连线进入距骨后，在外踝平面上，向内 打钉的角度和足的矢状面成角不能超过 35.68±0.79 度，向外打钉和足的矢状面成 角不能超过 15.14±1.01 度。 3. 在踝关节屈曲 90°时，可取外踝的平面，外踝和跟 腱中心连线的中点为体表进针点，以垂直此连线进入距骨后，在足的矢状面上， 向上打钉和外踝平面成角不能超过 15.96±0.79 度,向下打钉和外踝平面成角不能超 过 15.14±1.01 度。 【关键词】 距骨颈骨折； 闭合打钉；体表定位；角度 2 Applied anatomic study of Talar neck fracture closed reduction of the posterior screw fixation Abstract Objective:Base on the clinical anatomy ,We Systematic observe characteristics of talus and surrounding tissue, and measure anatomical data of it and relevant organizations,to find surface position of fracture of the talar neck closed reduction and screw fixation by posterior closure of the nail, the angle of the needle for Fixing the talar neck ,to provide anatomical data for minimally invasive treatment to prevent complications after neck fracture of the talar. Methods: This study used 12 adult fresh specimens, removed the skin, fascia, exposed Structure of rear talar. in the ankle buckling 90 °, observed the blood vessels, nerves,tendons among Achilles tendon, Lateral malleolus, and medial anterior malleolus and measured the anatomical data, and used statistical analysis to find the relation between them. And found out surface location for closure of the nail for screw fixation neck of the talar from Space between the Achilles tendon and Lateral malleolus（In the lateral malleolus Plane,take the midpoint of Connection of the lateral malleolus and the Achilles tendon for surface location to needle)。In ankle buckling in the 90 °, from the surface location for closure of the nail, we needled Vertically form the midpoint of Connection of the lateral malleolus and the Achilles tendon,and touched the talar once,under the guidance of the C-arm machine to needle , Adequate to the level and the sagittal plane as the surface.We needled a Kirschner wire L of parallel to the long axis of the foot form G point and needled other Kirschners to fix the Talar neck from below to above,Inside and outside. and Measured the angle between