骨科手术入路图解

脊柱，前路手术

Spine, Anterior Approaches /1

1 颈椎与颈胸椎交界区 Cervical Spine and Cervicothoracic Junction /2

1.1 C1~C2（C3）经口入路 /2

Transoropharyngeal Approach C1-C2(C3)

1.2 C3~T2 前方入路 /4

Anterior Approach to the Cervical Spine C3-T2

1.3 下颈椎及上胸椎前方入路（Cauchoix，Binet 及 Evrard 入路）/13

Anterior Approach to the Lower Cervical and Upper Thoracic Spine C4-T3 According to Cauchoix, Binet, and Evrard

2 胸椎 Thoracic Spine /18

2.1 T4~T11 经胸腔入路 /18

Transthoracic Approach to the Thoracic Spine T4-T11

2.2 前方经胸膜入路显露 T3~T11（Louis 入路）/29

Anterior Transpleural Approach to the Spine T3-T11 According to Louis

2.3 高位胸廓开胸术（T1~T4）/33

High Thoracotomy T1-T4

2.4 微创胸腔镜辅助下胸椎手术 /37

Thoracoscopic and Minimally Invasive, Thoracoscopy-Assisted Access to the Thoracic Spine

3 胸腰椎交界区 Thoracolumbar Junction /43

3.1 脊柱 T9~L5 水平经腹膜后胸膜外入路（Hodgson 入路）/43

Retroperitoneal Extrapleural Approach to the Thoracolumbar Spine T9-L5 According to Hodgson

3.2 胸腰椎 T4~L5 双重开胸入路（Bauer 入路）/55

Approach to Thoracolumbar Spine with Two-fold Thoracotomy T4-L5 According to Bauer

3.3 腹膜后胸膜外胸腰椎 T11~L5 入路（Mirbaha 入路）/59

Retroperitoneal Extrapleural Approach to Thoracolumbar Spine T11-L5 According to Mirbaha

4 腰椎及腰骶椎交界区 Lumbar Spine and Lumbosacral Junction /65

4.1 经腹膜后入路显露 L2~L5 /65

Retroperitoneal Approach to the Lumbar Spine L2-L5

4.2 经腹膜入路显露腰骶椎交界区（L4~S1）/69

Transperitoneal Approach to the Lumbosacral Junction L4-S1

4.3 微创经侧方入路显露 L2~L5 /73

Minimally Invasive Lateral Approach to the Lumbar Spine L2-L5

脊柱，后路手术

Spine, Posterior Approaches /77

5 颈椎 Cervical Spine /78

5.1 颈椎与枕颈交界区后路手术 /78

Posterior Approach to the Cervical Spine and Occipitocervical Junction

6 胸椎和腰椎 Thoracic and Lumbar Spine /83

6.1 T3~T10 肋横突关节切除入路 /83

Costotransversectomy T3-T10

6.2 胸腰椎后入路 /87

Posterior Approach to the Thoracic and Lumbar Spine

6.3 腰骶交界区 Wiltse 椎旁肌入路 /93

Paraspinal Approach to the Lumbosacral Junction According to Wiltse

6.4 椎板切开术及椎间盘摘除术的后路短切口入路 /94

Short Posterior Approach to the Lumbar Spine for Laminotomy and Removal of an Intervertebral Disk

骨盆与下肢

Pelvis and Lower Extremity /99

7 骨盆：骨盆环 Pelvis: Pelvic Ring /100

7.1 耻骨联合与骨盆前环入路 /100

Approach to the Symphysis and Anterior Pelvis

7.2 骨盆后环前方入路 /102

Anterior Approach to the Posterior Pelvis

7.3 骶骨后侧入路 /104

Posterior Approach to the Sacrum

7.4 置入骶髂螺钉的侧方微创入路 /105

Lateral Minimally Invasive Approach for Trans-sacroiliac Screw Placement

7.5 坐骨和耻骨入路 /106

Approach to the Ischium and Pubis

8 骨盆：髋臼 Pelvis: Acetabulum /109

8.1 髂腹股沟入路（Letournel 入路）/109

Ilioinguinal Approach According to Letournel

8.2 髋关节后侧入路（Kocher-Langenbeck 入路）/114

Posterior Approach to the Hip According to Kocher-Langenbeck

8.3 前侧微创入路（Stoppa 入路）/118

Anterior Limited Approach According to Stoppa

8.4 Judet 经髂骨入路 /120

Transiliac Approach According to Judet

8.5 Judet 髋臼入路 /124

Approach to the Acetabulum According to Judet

9 髋关节 Hip Joint /128

9.1 髋关节脱位后侧入路（Ganz 入路）/128

Posterior Approach to the Hip Joint with Dislocation According to Ganz

9.2 后侧微创入路 /131

Posterior Minimally Invasive Approach

9.3 经臀肌入路（Bauer 入路）/135

Transgluteal Approach According to Bauer

9.4 经臀肌微创入路 /138

Minimally Invasive Transgluteal Approach

9.5 髋关节前外侧入路 /141

Anterolateral Approach to the Hip Joint

9.6 髋关节前外侧微创入路 /145

Minimally Invasive Anterolateral Approach to the Hip Joint

9.7 髋关节前侧入路 /149

Anterior Approach to the Hip Joint

9.8 前侧微创入路 /152

Anterior Minimally Invasive Approach

9.9 髋关节关节镜入路 /156

Arthroscopic Approaches to the Hip Joint

10 股骨 Femur /161

10.1 前侧入路 /161

Anterior Approach

10.2 股骨骨髓腔的外侧近端入路 /164

Lateral Proximal Approach to the Medullary Cavity of the Femur

10.3 股骨外侧入路 /165

Lateral Approach to the Femur

10.3a 外侧入路：常规显露 /165

Lateral Approach—General Points

10.3b 外侧入路：显露股骨近端 /165

Lateral Approach—Exposure of the Proximal Femur

10.3c 外侧入路：显露股骨远端 /168

Lateral Approach—Exposure of the Distal Femur

10.4 外侧微创入路 /171

Minimally Invasive Lateral Approach to the Femur

10.5 内侧入路 /173

Medial Approach to the Femur

10.6 后侧入路 /177

Posterior Approach to Femur

10.7 股骨远端经关节的髓腔入路 /182

Transarticular Medullary Cavity Approach to the Distal Femur

11 膝关节 Knee /183

11.1 前内侧微创入路 /183

Anteromedial Minimally Invasive Approaches to the Knee Joint

11.2 前内侧髌旁入路 /187

Anteromedial Parapatellar Approach

11.3 小切口内侧入路 /193

Short Medial Approach to the Knee

11.4 前外侧入路 /195

Anterolateral Approach to the Knee Joint

11.5 后外侧入路（Henderson 入路）/197

Posterolateral Approach According to Henderson

11.6 后侧入路（Trickey 入路）/199

Posterior Approach to the Knee Joint According to Trickey

11.7 关节镜入路 /204

Arthroscopic Approaches

12 小腿 Lower Leg /207

12.1 胫骨骨髓腔的近端入路 /207

Proximal Approach to the Medullary Cavity of the Tibia

12.2 胫骨平台的直接后侧入路 /209

Direct Posterior Approach to the Tibial Plateau

12.3 胫骨平台的后内侧入路 /211

Posteromedial Approach to the Tibial Plateau

12.4 经腓骨截骨的胫骨平台后外侧入路 /213

Posterolateral Approach to the Tibial Plateau with Osteotomy of the Fibula

12.5 胫腓骨的后外侧入路 /216

Posterolateral Approach to the Tibia and Fibula

12.6 胫骨干的后内侧入路 /220

Posteromedial Approach to the Tibial Shaft

12.7 胫骨内侧和外侧微创入路 /222

Minimally Invasive Approach to the Medial and Lateral Tibia

12.8 腓骨外侧入路 /227

Lateral Approach to the Fibula

13 足 Foot /230

13.1 踝关节前侧入路 /230

Anterior Approach to the Ankle Joint

13.2 踝关节和距跟舟关节的前外侧入路 /233

Anterolateral Approach to the Ankle Joint and Talocalcaneonavicular Joint

13.3 Cincinnati 入路 /236

Cincinnati Approach

13.4 踝关节和距跟舟关节内侧的后内侧入路 /241

Posteromedial Approach to the Ankle Joint and the Medial Side of the Talocalcaneonavicular Joint

13.5 踝关节背外侧入路 /246

Dorsolateral Approach to the Ankle Joint

13.6 经内踝截骨的踝关节内侧入路 /249

Medial Exposure of the Ankle Joint with Osteotomy of the Medial Malleolus

13.7 关节镜入路 /251

Arthroscopic Approaches

13.8 内踝内侧入路 /253

Medial Approach to the Medial Malleolus

13.9 外踝入路 /254

Approach to the Lateral Malleolus

13.10 跟骨外侧入路 /255

Lateral Approach to the Calcaneus

13.11 跟骨和距跟舟关节的外侧入路 /256

Lateral Approach to the Calcaneus and Talocalcaneonavicular Joint

13.12 跟骨内侧入路 /258

Medial Approach to the Calcaneus

13.13 距跟舟关节外侧入路 /259

Lateral Approach to the Talocalcaneonavicular Joint

13.14 跖骨关节前侧入路 /262

Anterior Approach to the Metatarsal Joints

13.15 跖跗关节内侧入路 /264

Medial Approach to the Tarsometatarsal Joints

13.16 跖趾关节足底入路 /267

Plantar Approach to the Metatarsophalangeal Joints

13.17 第 1 跖趾关节内侧入路 /270

Medial Approach to the Metatarsophalangeal Joint of the Great Toe

13.18 跖骨、跖趾关节和趾间关节后侧入路 /272

Posterior Approaches to the Metatarsal Bones, Metatarsophalangeal Joint, and Interphalangeal Joint

13.19 趾屈肌腱的足底入路 /272

Plantar Approach to the Toe Flexor Tendons

13.20 第 2 趾伸肌入路 /273

Extensor Approach to the Second Toe

肩部与上肢

Shoulder and Upper Extremity /277

14 肩胛骨与锁骨 Scapula and Clavicle /278

14.1 锁骨与肩锁关节的手术入路 /278

Approach to the Clavicle and Acromioclavicular Joint

14.2 胸锁关节的手术入路 /280

Approach to the Sternoclavicular Joint

14.3 肩胛骨的手术入路 /281

Approach to the Scapula

15 肩关节 Shoulder /287

15.1 肩关节前方入路 /287

Anterior Approach to the Shoulder Joint

15.2 显露肱骨近端的肩关节前方延长入路 /292

Extended Anterior Approach to the Shoulder Joint with Exposure of the Proximal Humerus

15.3 肩关节前上入路 /293

Anterosuperior Approach to the Shoulder Joint

15.4 前外侧入路（Bigliani 入路）/294

Anterolateral Approach According to Bigliani

15.5 后上方入路（Gschwend 入路）/296

Posterosuperior Approach According to Gschwend

15.6 肩关节后方入路 /297

Posterior Approach to the Shoulder Joint

15.7 肩关节镜手术入路 /299

Arthroscopic Approach to the Shoulder

16 肱骨 Humerus /306

16.1 肱骨近端手术入路 /306

Proximal Approach to the Humerus

16.2 肱骨后方入路 /307

Posterior Approach to the Humerus

16.3 肱骨远端后方入路 /310

Distal Posterior Approach to the Humerus

16.4 肱骨前方入路 /311

Anterior Approach to the Humerus

16.5 肱骨外侧入路 /316

Lateral Approach to the Humerus

16.6 肱骨内侧入路 /319

Medial Approach to the Humerus

17 肘关节 Elbow /322

17.1 肘关节后方入路 /322

Posterior Approach to the Elbow Joint

17.2 肘关节外侧入路 /329

Lateral Approach to the Elbow Joint

17.3 肘关节内侧入路 /334

Medial Approach to the Elbow Joint

17.4 肘关节前方入路 /337

Anterior Approach to the Elbow Joint

17.5 肘关节镜入路 /342

Approaches for Elbow Arthroscopy

18 前臂 Forearm /346

18.1 桡骨前方入路（Henry 入路）/346

Anterior Approach to the Radius According to Henry

18.2 桡骨背外侧入路（Thompson 入路）/349

Dorsolateral Approach to the Radius According to Thompson

18.3 近端桡骨与尺骨手术入路（Boyd 入路）/352

Approach to the Proximal Parts of the Radius and Ulna According to Boyd

18.4 尺骨外侧入路 /354

Lateral Approach to the Ulna

18.5 桡骨远端的背侧入路 /356

Posterior Approach to the Distal Part of the Radius

18.6 尺骨远端的手术入路 /358

Approach to the Distal Portion of the Ulna

18.7 桡骨远端的掌侧入路 /359

Palmar Approach to the Distal Part of the Radius

19 腕关节 Wrist /362

19.1 镜下腕管松解的微创入路 /362

Minimally Invasive Approach for Endoscopic Carpal Tunnel Division

19.2 腕关节的背侧入路 /365

Posterior Approach to the Wrist

19.3 腕关节的掌侧入路 /368

Palmar Approach to the Wrist

19.4 腕关节镜入路 /372

Approach for Arthroscopy

20 手部 Hand /376

20.1 手部掌侧入路（Skoog 入路）/376

Approach to the Palm According to Skoog

20.2 Guyon 管尺神经显露 /380

Exposure of the Ulnar Nerve in the Canal of Guyon

20.3 腕舟骨的掌侧入路 /382

Palmar Approach to the Scaphoid

20.4 拇指腕掌关节的入路 /384

Approach to the Carpometacarpal Joint of the Thumb

20.5 第 1 伸肌间室的入路 /386

Approach to the First Extensor Tendon Compartment

20.6 手背和手指的背侧切口 /387

Dorsal Incisions Over the Dorsum of the Hand and Fingers

20.6a 背侧切口：常规显露 /387

Dorsal Incisions—General Points

20.6b 掌指关节的背侧入路 /387

Dorsal Approach to the Metacarpophalangeal Joint

20.6c 近节指间关节的背侧入路 /389

Dorsal Approach to the Proximal Interphalangeal Joint

20.6d 需要切断侧副韧带的近侧指间关节背侧入路 /390

Dorsal Approach to the Proximal Interphalangeal Joint Involving Transection of the Collateral Ligament

20.6e 远侧指间关节的背侧入路 /392

Dorsal Approach to the Distal Interphalangeal Joint

20.7 手指屈肌腱的入路 /393

Approach to the Finger Flexor Tendons

20.8 指屈肌腱和近侧指间关节的掌侧显露 /395

Palmar Exposure of the Flexor Tendon and Proximal Interphalangeal Joint

20.9 指屈肌腱的侧方中线切口 /397

Approach to the Finger Flexor Tendon Via the Midlateral Incision

20.10 拇指环形韧带的入路 /400

Approach to the Annular Ligament of the Thumb

附录  专业术语英汉对照 /404