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下肢截肢术的技术

Author
Venkat Kalapatapu, MD
Section Editors
Joseph L Mills, Sr, MD
John F Eidt, MD
Deputy Editor
Kathryn A Collins, MD, PhD, FACS
Translators
徐思越, 副主任医师

引言

施行下肢截肢术的目的是去除缺血、感染或坏死组织或局部无法切除的肿瘤，有时可以挽救生命。大部分患者行下肢截肢术的原因是下肢缺血(外周动脉疾病、栓塞)和糖尿病。肢体创伤是施行截肢术的第二主因，其余是因为恶性肿瘤[1,2]。

本文将总结大截肢术和足部截肢术的技术。下肢截肢术的指征、术前和术后治疗、并发症以及结局见其他专题。 (参见“下肢截肢术”)

外科解剖

髋和大腿 — 髋关节属于多轴的球窝关节。关节的韧带结构包括关节囊、髋臼唇、股骨头韧带、髂股韧带、坐股韧带、耻股韧带和髋臼横韧带。

包绕髋关节的肌肉分为三群：前群、后群和下群。前群肌肉由外向内包括股直肌、髂腰肌和耻骨肌。前群肌肉的前方是缝匠肌和阔筋膜张肌。后群肌肉包括梨状肌、闭孔内肌、股方肌和闭孔外肌。

大腿肌肉被分为三群(图 1)：前群包括缝匠肌、阔筋膜张肌和股四头肌(股内侧肌、股中间肌、股外侧肌和股直肌)；内侧群包括股薄肌、耻骨肌、长收肌、短收肌和大收肌；后群包括股二头肌、半腱肌和半膜肌。内收肌群沿着一条称为粗线的狭窄骨嵴附着于股骨后外侧。

                          

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Literature review current through: 2017-06 . | This topic last updated: 2017-05-02.
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