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目的为减少胫前动脉（ａｎｔｅｒｉｏｒ ｔｉｂｉａｌ ａｒｔｅｒｙ， ＡＴＡ）的损伤提供解剖学资料，探讨手术安全区。方法在３０具（６０侧）成人整尸上对ＡＴＡ、骨间膜孔等进行观测。结果ＡＴＡ与腘动脉的分叉点到骨间膜孔前侧缘距离为（１５．７± １．６）ｍｍ。ＡＴＡ第一段与腘动脉夹角的角度为１３５．５°±４．０°。ＡＴＡ经过骨间膜孔时第一段与第一段形成的夹角角度为１２２．４°± ９．０°。骨间膜孔呈卵圆形，纵径为（１７．１±０． ２） ｍｍ，横径为（ ８． ９ ± ０． ２） ｍｍ。在骨间膜孔 ＡＴＡ的上缘与腓骨头顶点距离为（ ５１． ２ ± ５． ４） ｍｍ。骨间膜孔 ＡＴＡ上缘与胫骨外侧髁上关节面外缘的距离为（６２． １±４． ０） ｍｍ。 ＡＴＡ与胫骨前缘的交叉点到内外踝连线中点的距离为（５．１± ０． ３） ｃｍ。本组共有 ３６例度开放性胫骨骨折病例，其中 ４例一期截肢，３２例用外固定器治疗。骨折愈合率８１％，平均愈合时间１０．５个月，感染率２５％。结论胫骨近段的前、中 １／３，中段的前 １／３和远段的后 １／３是股骨穿钉的安全区。
Objective To provide anatomical data to reduce the damage of anterior tibial artery (ATA) and to explore the safety of surgery. Methods ATA and interosseous membrane holes were observed in 30 adults (60 sides). Results The distance between the bifurcation point of ATA and popliteal artery to the anterolateral margin of interosseous membrane was (15.7 ± 1.6) mm. The angle between the first segment of ATA and the popliteal artery is 135.5 ° ± 4.0 °. The angle formed by the first segment and the first segment of ATA through the interosseous membrane was 122.4 ° ± 9.0 °. The interosseous membrane was oval, with a longitudinal diameter of (17.1 ± 0.2) mm and a transverse diameter of (8. 9 ± 0. 2) mm. The distance between the superior margin of the interosseous membrane ATA and the tip of the fibula head was (51.2 ± 5.4) mm. The distance between the superior margin of the interosseous membrane ATA and the outer margin of the supracondylar articular surface of the tibia was (62.1 ± 4.0) mm. The distance between the junction of ATA and the anterior tibia and the midpoint of the medial-lateral malleolus was (5.1 ± 0.3) cm. The group of 36 cases of open tibial fracture cases, of which 4 cases of amputation, 32 cases with external fixator treatment. Fracture healing rate of 81%, the average healing time of 10.5 months, the infection rate of 25%. Conclusions The anterior, middle 1/3, middle 1/3 and distal 1/3 of the proximal tibia are the safe areas of the femoral nail.