Фетальна топографія шкірних нервів гомілкової ділянки

Abstract

The purpose of the study was to determine the topographic and anatomical relationships of the cutaneous nerves of the lower leg in human fetuses of 4-6 months. Materials and methods. The study was performed on 27 preparations of human fetuses of 81.0-230.0 mm parietal-coccygeal length, using the methods of macromicroscopic preparation and morphometry. Results and discussion. In most of the studied fetuses, there was a classic variant of innervation of the skin of the lower leg region, both on the right and left. In other fetuses, variability in the number and length of cutaneous nerves in the lower leg region was found. The most interesting, from our point of view, were the anatomical variants of innervation of the skin of the lower leg region in the fetuses of 90.0, 158.0, 182.0, and 190.0 mm parietal-coccygeal length. Taking into account the individual and age anatomy of the cutaneous nerves of the leg in human fetuses provides not only the scientific value of the results, but also the rational use of knowledge in the practice of traumatologists, anesthesiologists and surgeons. The study of variants of innervation of the skin of the lower leg region in human fetuses from the standpoint of modern macroscopic anatomy is considered relevant and promising. The need to clarify the topographic and anatomical features of the innervation of the skin of the lower leg region in human fetuses of different ages is due to the search for ways to prevent iatrogenic damage to the cutaneous nerves of the shin when performing surgical and anesthetic manipulations on the structures of this area, since the establishment of the anatomical variability of the skin nerves and branches allows to choose the optimal tactics of surgical intervention. In the literature, there are fragmentary data on the fetal topography of the cutaneous nerves of the lower leg region. Conclusion. In fetuses of 90.0 mm and 158.0 mm parietal-coccygeal length, the innervation of the skin of the anterior-upper surface of the lower leg region was provided by two cutaneous branches from the tibial nerve. In the fetus of 190.0 mm parietal-coccygeal length lateral sural cutaneous nerve was not involved in the formation of the sural nerve, the area of its innervation was limited to the proximal two-thirds of the tibia. Innervation of the lateral border of the foot and lateral bone, in this case, provided only the medial sural cutaneous nerve from the tibial nerve. In the fetus of 182.0 mm parietal-coccygeal length medial sural cutaneous branches are represented by a single independent nerve trunk, from which at different angles short sensitive branches began