Applied anatomy on blood supply and operative approaches of talus
LI Yuan-Zhou, YANG Mao-Wei, YANG Cheng-Gang, GUO Bao-Lei, WANG Zhen-Feng
Chinese Journal of Clinical Anatomy ›› 2012, Vol. 30 ›› Issue (2) : 127-130.
Applied anatomy on blood supply and operative approaches of talus
Objective To explore arterial supply of the talus and the related operative approaches. Methods 20 fresh adult foot specimens, with no vascular disease, and injected with red latex, were used in this study. Ankle joints were dissected at different levels, followed by the observation and comparison with the casting specimens. We measured external diameter of main arteries nourishing talus, and dissected it's origin, courses, distributions and anastomoses. Results Talus was mainly supplied by the deltoid branch, posterior tubercule branch, and the tarsal canal artery of the posterior tibial artery with the diameter of (0.98±0.04)mm, (0.25±0.06)mm and (1.02±0.1)mm, respectively. Those branches distributed mainly to the posteromedial aspect of the ankle joint. The superior cervical branch and the tarsal canal artery issued from the anterior tibial artery, with the diameter of (0.3±0.1)mm and (1.08±0.6)mm, distributed to the anterior aspect of the ankle joint. The calcaneal branch and the perforating branch arised from the peroneal artery, with the diameter of (0.42±0.18)mm and (0.69±0.12)mm, distributed to posterolateral aspect of the ankle joint. Extensive vascular anastomoses among them were recognized on the cast specimens of foot and ankle. Conclusions The anteromedial approach to the talus between the anterior tibial artery and the deltoid artery causes least damage to talus blood supply.
[1] Mulfinger GL, Trueta J. The blood supply of the talus
[J].J Bone Joint Surg Br, 1970, 52(6):160-164.
[2] Gelberman RH, Mortensen WW. The arterial anatomy of the talus
[J]. Foot Ankle,1983, 4(2):64-72.
[3] Haliburton RA, Sullivan CR, Kelly PJ, et al. The extraosseous and intra-osseous blood supply of the talus
[J] . J Bone Joint Surg Am, 1958, 40(7):1115-1120.
[4] 王岩,王满宜,蒋协远,等.距骨颈骨折的治疗
[J].中华外科杂志,2002,40(5):366-368.
[5] 邵云潮,张光健,周建平.距骨的血液供应及其临床意义
[J].中华骨科杂志,1997,17(7):457-460.
[6] Alexander IJ, Watson JT. Step cut osteotomy of the medial malleolus for exposure of the medial ankle joint space
[J].Foot Ankle, 1991,11(1):242-243.
[7] Adelaar RS. The treatment of complex fractures of the talus
[J]. Orthop Clin North Am 1989, 20(4):691-707.
[8] Piazza SJ,Lewis GS.Computational models of the foot and ankle
[J].Current Opinion in Orthopaedics,2003,14(1):79-83.
[9] Edited by S.Terry Canale MD,James H. Beaty MD Editorial Assistance by Kaugherty and Linda Jones Art Coordination, Campbell’s Opetative Orthopaedics
[M]. 2011:3808-3809.
[10]Ziran BH, Abidi NA, Scheel MJ. Medial malleolar osteotomy for exposure of complex talar body fractures
[J]. J Orthop Trauma, 2001, 15(7):513-518.
[11] Wallen EA, Fallat LM. Cresentic transmalleolar osteotomy for optimal exposure of the medial talar dome
[J]. J Foot Surg, 1989, 28(5):389-394.
[12] 吴富章,卜海富,蔡靖宇,等.复杂距骨骨折脱位的手术策略
[J].中国骨与关节损伤杂志, 2007, 22(5): 385-387.
[13] VallierH A,Nork S E, BareiD P, et al. Talar neck fractures: re-sults and outcomes
[J]. J Bone Joint Surg Am, 2004, 86(8): 1616-1624.
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