Kuhlmann J N, Guerin-Surville H, Baux S
Laboratoire d'Anatomie, Faculté de Médecine Pitié-Salpétrière, Paris.
Bull Assoc Anat (Nancy). 1992 Jun;76(233):27-34.
The synovial sheaths of the flexor digitorum of 70 pieces of fresh cadavers have been studied on the whole of their length as far as the basis of the fingers: 20 have been injected with a latex or a physiologic solution, after the ablation of the palmar aponeurosis and of the superficial palmar arch. The arteries of the 50 other pieces have been injected with coloured latex solution from humeral artery. The proximal limit of the superficial sheaths is located 5 centimetres above the radiocarpal articular line and this of the deep sheaths 7 centimetres. In the metacarpal area, the superficialis central sheath presents peritendinous expansions, which realise an uninterrupted connection with each digital sheath. It is the aponeurotic and vascular extrinsic compressions, which simulate the interruption of these expansions. The proximal synovial arteries have a muscular origin. The antibrachial collateral arteries, 3 pairs in number, arise from the radial and the ulnar arteries. The distal synovial arteries come from the palmar arches and from their branches: superficial branches for the superficial sheaths and deep branches for the deep sheaths. There is many anastomoses between the different synovial arteries. Two are particularly developed and connect the proximal arteries to the palmar arches: the superficial longitudinal anastomotic artery; which runs close along the medial edge of the median nerve; the deep longitudinal anastomotic artery, which gives the nutritious branches for the tendons of the flexor digitorum. This disposition allows to create two synovial flaps of gliding and vascular help, centred on the anastomotic longitudinal arteries, pediculated on the volar archs and distal-ward rotated.(ABSTRACT TRUNCATED AT 250 WORDS)
对70块新鲜尸体的指屈肌腱滑膜鞘进行了全长直至手指基部的研究:20块在切除掌腱膜和掌浅弓后注入乳胶或生理溶液。另外50块的动脉从肱动脉注入有色乳胶溶液。浅腱鞘的近端界限位于桡腕关节线以上5厘米处,深腱鞘的近端界限位于7厘米处。在掌骨区域,浅腱鞘中央鞘有腱周扩张,与每个指腱鞘实现不间断连接。是腱膜和血管的外在压迫模拟了这些扩张的中断。近端滑膜动脉起源于肌肉。臂 collateral动脉有3对,分别起自桡动脉和尺动脉。远端滑膜动脉来自掌弓及其分支:浅支供应浅腱鞘,深支供应深腱鞘。不同滑膜动脉之间有许多吻合。有两条特别发达,将近端动脉与掌弓相连:浅纵吻合动脉,沿正中神经内侧缘走行;深纵吻合动脉,为指屈肌腱提供营养分支。这种布局允许以吻合纵动脉为中心创建两个具有滑动和血管辅助功能的滑膜瓣,以掌弓为蒂并向远端旋转。(摘要截于250字)