Leversedge Fraser J, Ditsios Konstantinos, Goldfarb Charles A, Silva Matthew J, Gelberman Richard H, Boyer Martin I
Department of Orthopaedic Surgery, Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, MO 63110, USA.
J Hand Surg Am. 2002 Sep;27(5):806-12. doi: 10.1053/jhsu.2002.35080.
The vascular anatomy of the flexor digitorum profundus (FDP) tendon insertion is described by using a vascular injection and modified Spalteholtz tissue clearing protocol in 36 human cadaver digits. A consistent dense palmar and dorsal vascular supply to the tendon at its insertion into the distal phalanx was observed based on sources from both the distal phalanx and the vinculum brevis profundus. Multiple palmar-dorsal vascular interconnections were seen between these spatially distinct vascular networks, a finding not observed previously in studies of the vascular anatomy of tendon or ligament insertions. Additionally a well-defined dorsal zone of hypovascularity was identified subjacent to the volar plate of the distal interphalangeal joint, within 1 cm of the tendon insertion. Recognition of the vascular supply to the FDP insertion at the distal phalanx permits further evaluation of the vascular, histologic, and cellular events after FDP tendon avulsion and improves the understanding of the biologic response mechanisms involved in bone-tendon healing.
通过对36例人类尸体手指采用血管注射和改良的斯帕尔茨组织透明化方案，描述了指深屈肌腱（FDP）止点的血管解剖结构。基于来自远节指骨和短屈肌腱纽的血供，观察到在肌腱插入远节指骨处有一致的密集掌侧和背侧血管供应。在这些空间上不同的血管网络之间可见多个掌侧-背侧血管相互连接，这一发现以前在肌腱或韧带止点的血管解剖研究中未观察到。此外，在远节指间关节掌板下方、距肌腱止点1厘米范围内，确定了一个明确的无血管背侧区。认识到远节指骨处FDP止点的血管供应，有助于进一步评估FDP肌腱撕脱后的血管、组织学和细胞事件，并增进对骨-肌腱愈合所涉及的生物学反应机制的理解。
