Jiang Hua, Chen Gang, Liu An-tang
Department of Plastic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
Zhonghua Zheng Xing Wai Ke Za Zhi. 2006 Sep;22(5):383-7.
Report on the intramuscular innervation and vascular supply of the flexor carpi ulnaris (FCU) and the flexor carpi radialis (FCR), the musculo tendon architecture, i.e., the physiological cross-sectional area and fiber length; and explore the possibility of splitting FCU and FCR into 2 parts with individual independent function.
Anatomic study, angiogram and Sibler's staining technique were carried on human and monkey cadavers. The electric stimulation study was used to reveal independent contraction of each part on monkey FCU and FCR.
It was found that the innervation and blood supply of FCU and FCR come primarily from the proximal neurovascular pedicles. The primary nerve and vascular branch supplying the muscles were divided into 2 subbranches and inserted the proximal quarter of the muscle belly. Then each of the nerve and blood subbranches mn parallel to the central tendon on each side supplying the radial and ulnar compartments of FCU and FCR toward the distal musculotendinous junction. Independence of function of each compartment was confirmed in electrical stimulation studies in primate FCU and FCR. The results of each compartment of the human FCU and FCR architectures were measured and compared with the extensor pollicis longus and the extensor digitorum communis to the index, middle, ring, and small.
Both FCU and FCR can be split from the distal to the proximal along its tendon into 2 independently functioning neuromuscular compartments. Both radial compartment and ulnar compartment have its own nerve and adequate blood supply. And the study provides useful information for enabling the local transfer of the two muscles as a whole or two separate compartments, both for resurfacing skin soft-tissue defects and for functional tendon transfer.
报告尺侧腕屈肌(FCU)和桡侧腕屈肌(FCR)的肌内神经支配和血管供应、肌肉肌腱结构,即生理横截面积和纤维长度;并探讨将FCU和FCR分成具有独立功能的两部分的可能性。
对人和猴尸体进行解剖学研究、血管造影和西布勒染色技术。采用电刺激研究揭示猴FCU和FCR各部分的独立收缩情况。
发现FCU和FCR的神经支配和血液供应主要来自近端神经血管蒂。供应肌肉的主要神经和血管分支分为两个亚分支,并插入肌腹的近端四分之一处。然后,每个神经和血管亚分支在中央肌腱两侧平行走行,向远端肌肉肌腱连接处供应FCU和FCR的桡侧和尺侧肌室。在灵长类动物FCU和FCR的电刺激研究中证实了每个肌室功能的独立性。测量了人类FCU和FCR各肌室的结构结果,并与拇长伸肌以及示指、中指、环指和小指的指总伸肌进行了比较。
FCU和FCR均可沿其肌腱从远端到近端分成两个具有独立功能的神经肌肉肌室。桡侧肌室和尺侧肌室都有自己的神经和充足的血液供应。该研究为整体或两个独立肌室局部转移这两块肌肉提供了有用信息,可用于修复皮肤软组织缺损和进行功能性肌腱转移。