关键词: 胫骨近端骨折, 手术入路, 血供, 神经支配

Abstract:

Objective　To provide anatomic basis for "T"operational approach in the treatment of proximal tibial fractures.　Methods　After perfusing with red plastics via the femoral artery of 4 adult leg specimens, the distributions of the vessels and the nerves around the upper tibia were described in details. While, "T" approaches were simulated on other 4 specimens and analyzed.　Results　(1) The blood supply of the superior tibia consisted of the epiphyses，epiphysial and metaphyseal arteries, the tibial nutrient artery and the periosteal arteries. The nerve distribution concerned with infrapatellar branch of saphenous nerve and anterior tibial recurrent nerve. (2) Only the infrapatellar branch of the descending genicular artery was broken during "T" approaches, but the nerve branches were not found. Red plastics could be seen in different tissues. "T" approaches could explore the proximal tibia and the surface of knee joint completely.　Conclusions　(1) There are abundant vessel networks around "T" approach area. (2) "T" approach is more valuable, for its sufficient surgical exposure, convenient and safe operative procedure.

Key words: Proximal tibia, Fracture, Approach, blood supply, Nerve distribution