Schweitzer Timothy P, Rayan Ghazi M
Hand Surgery Section, Orthopedic Surgery Department, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73112, USA.
J Hand Surg Am. 2004 Sep;29(5):898-902. doi: 10.1016/j.jhsa.2004.04.022.
The purpose of this study was to examine the anatomy of the terminal tendon (TT) and its relationship to adjacent structures.
The extensor tendons of 56 cadaveric digits (52 fresh-frozen and 4 formalin-preserved) underwent anatomic dissection.
The TT is a segment between the convergence of the lateral bands proximally and the bony insertion in the phalanx distally. The ulnar lateral bands were thicker than the radial bands. The average distance from the TT insertion to the germinal matrix of the nail bed was 1.4 mm. The triangular ligament (TL) is a thin layer of transverse fibers between the lateral bands proximal to the TT. The dimensions of the TT and the TL vary relative to the size of the digit with the largest often occurring in the middle, followed by the ring, index, and small finger. The transverse retinacular ligament (TRL) had a dorsal attachment to the lateral bands and was much more defined and distinct than the oblique retinacular ligament. The ulnar TRL often was thicker than the radial TRL.
The TT is the primary structure responsible for extending the distal interphalangeal (DIP) joint. The function of the adjacent retinacular structures is to provide stability to the TT. The thin nature and proximity of the TT to the nail matrix must be kept in mind during surgery. Knowledge of the TT anatomy is necessary for further study of its kinematics and pathology and for diagnosis and management of its disorders.
本研究的目的是检查终末肌腱（TT）的解剖结构及其与相邻结构的关系。
对56个尸体手指的伸肌腱（52个新鲜冷冻的和4个福尔马林保存的）进行了解剖。
TT是近端外侧束汇合处与远端指骨骨性附着点之间的一段。尺侧外侧束比桡侧束厚。TT附着点到甲床生发基质的平均距离为1.4毫米。三角韧带（TL）是TT近端外侧束之间的一层横向纤维薄层。TT和TL的尺寸相对于手指大小而变化，最大的通常出现在中指，其次是环指、示指和小指。横向支持韧带（TRL）背侧附着于外侧束，比斜向支持韧带更明确和清晰。尺侧TRL通常比桡侧TRL厚。
TT是负责伸展远侧指间（DIP）关节的主要结构。相邻支持结构的功能是为TT提供稳定性。手术过程中必须牢记TT的薄质性及其与甲床的接近程度。了解TT的解剖结构对于进一步研究其运动学和病理学以及诊断和处理其疾病是必要的。
