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手部背侧伸肌腱的解剖变异。

The anatomical variations of the extensor tendons to the dorsum of the hand.

作者信息

Celik Servet, Bilge Okan, Pinar Yelda, Govsa Figen

机构信息

Department of Anatomy, Faculty of Medicine, Ege University, Izmir, Turkey.

出版信息

Clin Anat. 2008 Oct;21(7):652-9. doi: 10.1002/ca.20710.

Abstract

To lead a quality life, tendon repair must be performed in a trauma causing damage to the extensor tendon of the hand. The aim of this study is to study the structures that can be used as donor tendons. Fifty-four dissected adult hands were examined to study the pattern of the extensor tendons on the dorsum of the hand. The most common distribution patterns of the extensor tendons of the fingers were as follows: a single extensor indicis proprius (EIP) tendon which inserted ulnar to the extensor digitorum (ED)-index; a single ED-index; a single ED-middle; a single ED-ring; an absent ED-little; a double extensor digiti minimi (EDM), and a single ED-ring to the little finger. The frequency of the number of tendons is as follows: a single (87.03%) EIP, a single ED-index (100%), a single (92.6%) ED-middle, a single (75.9%) ED-ring, and an absent (68.5%) or a single (24.1%) ED-little. A double (88.9%) EDM tendons were seen. The thickest type of juncturae tendinum (JT) is found primarily between the ring and little fingers (90%). Suitable excessive tendon and the thickest JT as donor tendon were found in the fourth intermetacarpal space. The present findings, especially the fourth intermetacarpal space, may explain why incisions on the dorsum of the hand should be large and performed with particular care. It is necessary to have a thorough understanding of the arrangements of the multiple extensor muscles and their junctural connections of the hand when tenoplasty or tendon transfer is required.

摘要

为了过上高质量的生活,必须对手部伸肌腱造成损伤的创伤进行肌腱修复。本研究的目的是研究可作为供体肌腱的结构。检查了54只解剖后的成人手,以研究手背伸肌腱的形态。手指伸肌腱最常见的分布模式如下:一条单独的示指固有伸肌腱(EIP),插入到指总伸肌(ED)-示指的尺侧;一条单独的ED-示指;一条单独的ED-中指;一条单独的ED-环指;ED-小指缺如;两条小指固有伸肌腱(EDM),以及一条从环指到小指的单独的ED。肌腱数量的频率如下:一条单独的(87.03%)EIP,一条单独的ED-示指(100%),一条单独的(92.6%)ED-中指,一条单独的(75.9%)ED-环指,以及缺如的(68.5%)或一条单独的(24.1%)ED-小指。可见两条(88.9%)EDM肌腱。腱间结合(JT)最厚的类型主要见于环指和小指之间(90%)。在第四掌骨间隙发现了合适的多余肌腱和最厚的JT作为供体肌腱。目前的发现,尤其是第四掌骨间隙,可能解释了为什么手背的切口应该大一些并且要格外小心进行。当需要进行腱成形术或肌腱转移时,有必要全面了解手部多条伸肌的排列及其连接情况。

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