腓跟的

Method］reversed sural neurofasciocutaneous flap with muscle was applied for repairing the soft tissue defect simultaneous open fracture of tibia lower section 6 cases,the soft tissue defect simultaneous chronic osteomyelitis of tibia lower section 5 case,the soft tissue defect of sole of foot simultaneous calcaneus epicarp 3 case, the soft tissue defect of sole of foot simultaneous calcaneus osteomyelitis or dead space 2 case. the scope of the flap was 18 c m×13 cm～11 c m×7 c m and that of the gastrocnemius flap was 4 cm×3 cm～9 c m×6 cm,the thickness was 1～3 cm,the skin flap was bigger than the muscle flap.

方法］自2004年6月以来，应用带肌肉的腓动脉穿支蒂腓肠神经营养血管皮瓣修复小腿下段及足踝部软组织缺损16例，其中胫骨下段开放性骨折伴软组织缺损6例，胫骨下段软组织缺损伴慢性骨髓炎5例，足后跟足底软组织缺损伴跟骨表层组织缺损3例，跟骨骨髓炎伴窦道2例，皮瓣面积30 cm×10 cm～6 cm× 4.5cm，切取的腓肠肌瓣面积4 cm×3 cm～9 cm×6 cm，肌肉厚度1～3 cm，皮瓣面积比肌瓣的面积要大。

Anatomical study proved:①.4~8 nutritional vessels of sural nerve –small saphenous vein were the intermuscular perforators of peroneal artery, the furthermost one located at(1.0±1.3)cm above the tip of external malleolus with diameter (0.6±0.2)mm;②.2~6 musculocutaneous perforators were given off by the artery of outer head of gastrocnemius muscle to supply nutrition to the sural nerve-small saphenous vein;③.intermuscular perforators from peroneal artery supplied blood to fibula and outer head of soleus muscle.the perforators with an average outer diameter of （1.3-1.6）cm gave off cutaneous branch ,fascial branch and nutritional vessels to the sural nerve-small saphenous vein,which formed the vessel chain of the sural nerve-small saphenous vein ,sub-fascial and suprafascial vessel net.

结果：1、解剖实验证实：①、腓肠神经-小隐静脉营养血管来自腓动脉肌间隔穿支4～8支，最远的跟外侧动脉穿支距外踝尖上(1.0±1.3)cm，外径(0.6±0.2)mm。②、腓肠肌外侧头动脉沿途发2-6支的肌皮穿支营养腓肠神经-小隐静脉。③、腓动脉肌间隔穿支营养腓骨、比目鱼肌外侧半。上述穿皮支平均外径在0.3～1.6mm，发出皮支、筋膜支、腓肠神经-小隐静脉营养血管，形成腓肠神经-小隐静脉血管链以及深、浅筋膜血管网。

Results: Anterior talofibular ligament on axial plane, calcaneo fibular ligament on coronal and oblique axial planes, posterior talofibular ligament on all of four planes, cervical ligament on coronal and sagittal planes, interosseous talocalcaneal ligament on coronal, sagittal and oblique axial planes, lateral bundle of inferior extensor retinaculum on coronal and sagittal planes, medial and intermediate bundle on coronal planes, can be most clearly observed.

结果：距腓前韧带在轴位，跟腓韧带在冠状位和斜轴位，距腓后韧带在四个方位，颈韧带在冠状位和矢状位，距跟骨间韧带在冠状位、矢状位和斜轴位，伸肌下支持带浅束在冠状位和矢状位，中束和深束在冠状位，能清楚观察各韧带的形态和毗邻关系。

When the foot contacted on a complex surface such as lateral side of a sport shoe, at 12.6ms after initial contact the aforementioned ligaments were torn even 100% of the original ligament strength.

当角度增加至30度时会进而增加跟腓韧带伤害(24~49.5Mpa)；当接触平面如运动鞋时，100%之韧带劲度亦在12.6ms造成前距腓及距腓韧带的断裂，而有扭伤经验者其可能的韧带拉伤提前至10.8ms，此结果与临床相符合。

This repairing method posses such advantages as convenient dissection,satisfactory appearance,and good functional recovery,indicating that it is a good choice to treat soft tissue defects of heel or tendo calcaneus.

应用腓动脉终末支为血供的足外侧皮瓣局部转移或形成岛状皮瓣修复跟腱和足跟区软组织缺损，解剖简便，修复后外观及功能恢复良好，是临床上修复足跟及跟腱区皮肤软组织缺损的良好选择。

Carefully preserve the calcaneofibular and talofibular ligaments to serve as a hinge and to maintain the integrity of the ankle after operation.

为了保持术后踝关节的完整与稳定，应仔细保护跟腓与距腓韧带，使其成为外踝牵开时的枢轴。

Anatomic classificationof ankle sprains is based on the number of affected ligaments.First-degree sprain is characterized by a partial or completetear of the anterior talofibular ligament. In second-degreesprain, both the anterior talofibular and calcaneofibular ligamentsare either partially or completely torn. Third-degree sprainconsists of injuries to the anterior talofibular, calcaneofibular,and posterior talofibular ligaments.

踝扭伤的解剖分型是根据受累的韧带进行的。1度扭伤的特点是前距腓韧带的部分或完全撕裂。2度扭伤是前距腓韧带和跟腓韧带同时部分或完全撕裂。3度扭伤是前后距腓韧带和跟腓韧带同时损伤。

Results When the foot was in a relaxing position, the optimal position to observe anterior talofibular ligament with MRI was transverse orientation, to calcaneofibular ligament was transverse oblique, to posterior talofibular ligament and cervical ligament was coronal and to interosseous talocalcaneal ligament was sagittal orientation. The identifying signs of the ligaments were described.

结果 当足呈自然放松位时，距腓前韧带在横断位，跟腓韧带在斜横断位，距腓后韧带在冠状位，颈韧带在冠状位，距跟骨间韧带在矢状位断面上，为最佳观测方位，并提出了各韧带在断面上的辨认标志。

ETHODS: The gastrocnemius bundle branch and soleus muscle bundle branch of the right achilles tendon were sutured after surface skin and subcutaneous tissue discission. The gastrocnemius bundle branch was transected at 2 cm above calcaneal bone insertion and a 2-cm silicone tube was applied to separate the site of suture using 5-0 modified Kessler method. The site of suture was treated with nothing in silicone tube as the blank control group. In other three groups, the site of suture was treated with 100, 50, 10 ng VEGF in silicone tube at the operation day and 7, 14, 21 days post-operation.

切开家兔右侧跟腱表面皮肤、皮下组织，钝性分离跟腱的腓肠肌束支和比目鱼肌束支，于跟骨止点上方约2 cm处横行切断跟腱腓肠肌束支，将2 cm长硅胶管套入一侧断端，5-0缝合线改良Kessler法缝合跟腱，缝合后将硅胶管覆盖跟腱缝合处，空白组硅胶管内不加药，其他3组于手术当日及术后第7，14，21天往硅胶管内加入血管内皮生长因子100，50，10 ng。

During the operation, a drill, 4.5 mm diameter, was used to drill a hole on the lateral ankle; one anchor was drilled into the talus at the end of anterior talofibular ligament, another one was threaded on the calcaneus; the allogeneic tendon was permeated through the hole on the lateral ankle, maintaining ankle neutral and moderate valgus position.

术中应用4.5 mm直径的钻头在外踝处打孔，在距腓韧带的距骨止点处拧入锚钉一枚，在跟骨跟腓韧带止点处拧入锚钉一枚，然后将异体肌腱在外踝骨孔处穿过，维持踝关节于伸曲中立位和中度外翻位，将肌腱的两端分别用锚钉的尾线缝合固定，术后石膏托固定踝关节于伸曲中立位和轻度外翻位。

The absorption and distribution of chromium were studied in ryeusing nutrient culture technique and pot experiment.

采用不同浓度K2CrO4(0，0.4，0.8和1.2 mmol/L)的Hoagland营养液处理黑麦幼苗，测定铬在黑麦体内的亚细胞分布、铬化学形态及不同部位的积累。

By analyzing theory foundation of mathematical morphology in the digital image processing, researching morphology arithmetic of the binary Image, discussing two basic forms for the least structure element: dilation and erosion.

通过分析数学形态学在图像中的理论基础，研究二值图像的形态分析算法，探讨最小结构元素的两种基本形态：膨胀和腐蚀；分析了数学形态学复杂算法的基本原理，把数学形态学的部分并行处理理念引入到家实际应用中。