Safe Zone at the Medial and Lateral Calcaneus and the Proximal Tibia for Percutaneous Pin Placement: An Anatomical Study
|School||Hebei Medical University|
|Keywords||Safe area Blood vessels and nerves Percutaneous Calcaneus Knee joint capsule Complication Palpable anatomical landmarks|
The purpose of: delimitation the calcaneus of people inside and outside of, Anatomy of a relatively safe zone of proximal tibial external fixation pin needle position, provide the basis for the safe operation of clinicians surgery, reduce the incidence of clinical complications. Methods: four anti-corrosion adult male body, 8 lower limb specimens, specimens knee capsule are complete unspoiled, ankle, heel, lateral deep structure is not yet anatomy, foot, knee look no trauma, deformities and other disorders. The inside of each specimen heel: Take calcaneus innermost next point mark for the point \(Fig.1) dissecting the medial calcaneal nerve (MCN), the last branch of the lateral plantar nerve (MPLPN), lateral plantar nerve (LPN), medial plantar nerve (MPN) and posterior tibial artery (PTA) or lateral plantar artery (LPA), the medial plantar artery (MPA). Measurement AB, AC distance (in mm data in this article as a unit, and accurate to two decimal places), were used to measure the distance of the point A AB, AC line neurovascular structure AB, AC line cross-pitch. Calculate the neurovascular structures with AB, AC line cross-dot pitch point A distance accounted for a percentage of the AB, AC line to determine the relative safety of the inside of the heel area. The specimen lateral heel: Take calcaneus outermost after the point marked \saphenous vein (SSV) trunk, measure the distance from the DE, DE online neurovascular structures and DE line cross-pitch distance of the point D were measured. Calculate the distance of the neurovascular structures and DE line cross-pitch point D accounted for a percentage of the DE line to determine the relative safety of the lateral calcaneal area. Anatomy of the proximal tibia, revealing the the knee capsule all directions in the proximal tibia minimum return polyline. The tibial platform imaginary circular dial (in front of 0 or 12, just behind is 6 points) as the measurement position, points with clockwise direction, measured sequentially, recorded at each point of the knee joint capsule synovial layer lowest return polyline (i.e., the joint capsule and the fiber layer is attached to the line level) from the distance of the outer edge of the alignment orientation of the tibial platform. Unified subject to the right knee clockwise, statistical data, to determine the knee capsule the back polyline range in the proximal tibia, and to determine the proximal tibia percutaneous safe area. Results: the inside of the heel: the AB line the inside of the heel nerves, the last branch of the lateral plantar nerve, lateral plantar nerve, medial plantar nerve, posterior tibial artery and the line AB cross-pitch distance of the point A of the AB line distance percentage of were 22%, 50%, 55%, 64%, 58%. That is the most important neurovascular structures located in the AB line on the 1/2. Percentage of the AC line the inside of the heel nerves, the last branch of the lateral plantar nerve, lateral plantar nerve, medial plantar nerve, lateral plantar artery medial plantar artery and AC line cross-pitch distance of the point A of the AC line distance were 14%, 38%, 48%, 64%, 41%, 58%. That is the most important neurovascular structures in the AC line on 2/3. The the lateral calcaneal: DE online lateral calcaneal nerve, sural nerve, small saphenous vein and DE line cross-pitch distance of the point D of the DE line from the percentage was 20%, 66%, 62%. That is the most important neurovascular structures in the DE line on 2/5. Knee joint capsule: lowest outside back off point is located at about 5:00 near the average of 10.27mm, 95% confidence interval (8.18 to 12.36). The inside of the lowest return turning point is located at about 10:00 near the average of 5.94mm, 95% confidence interval (5.25 to 7.6). Conclusion: The inside of the heel, the line AB 1/2 1/3 of the area after the AC line for percutaneous pinning a relatively safe area, behind some of the more secure. The lateral calcaneal DE line 3/5 percutaneous relatively safe area. Lateral knee joint capsule minimum back off point is located at about 5:00 near the bottom of the articular surface 12.36mm percutaneous relatively safe area. Medial joint capsule the lowest back off point is located around 10 points below the articular surface 7.6mm percutaneous relatively safe area.