Mataliotakis G, Doukas M, Kostas I, Lykissas M, Batistatou A, Beris A
Orthopaedic Department, University of Ioannina, Ioannina, Greece.
J Hand Surg Am. 2009 Oct;34(8):1413-21. doi: 10.1016/j.jhsa.2009.05.007. Epub 2009 Aug 15.
To investigate the different types of innervation and the presence of mechanoreceptors in relation to the structural composition of the scapholunate interosseous ligament and to correlate the findings with the known mechanical properties of the ligament subregions.
Six fresh cadaveric scapholunate interosseous ligaments were divided into their 3 subregions: dorsal, palmar, and proximal. The microscopic features were investigated with use of a standard hematoxylin-eosin stain and immunostains for S-100, neurofilaments, neuron-specific enolase, protein gene product 9.5, CD31, and smooth muscle actin. The connective tissue structural composition and the presence of blood vessels and neural structures (myelinated and unmyelinated nerve fibers and mechanoreceptors) were investigated. The macroscopic anatomic details were also noted.
The palmar subregion consists of structured, densely collagenized tissue at the core, surrounded by looser connective tissue. Myelinated nerve fibers forming fascicles accompany the interspersed blood vessels inside the ligament substance. Their concentration is greater in the proximal part of the palmar subregion, reaching a distance of approximately 150 mum from the ligament free surface. The dorsal subregion has similar structure to the palmar one, but the fibrous tissue ratio and density are higher. The proximal subregion consists of chondroid matrix and of loose connective tissue at its core. The radio-scapholunate ligament insertion is noted at the palmar aspect of the proximal subregion. Pacinian and other sensory corpuscles were found mostly at the palmar and proximal subregions.
The scapholunate interosseous ligament is a richly innervated ligament that contributes to carpal proprioception, a fundamental element of dynamic wrist stability. The palmar subregion, apart from its major mechanical role, contains the greatest amount of the neural structures and mechanoreceptors. The dorsal subregion, with densely packed collagen fibers and limited innervation, functions mainly to constrain the scaphoid-lunate relative motion.
研究舟月骨间韧带结构组成相关的不同类型神经支配及机械感受器的存在情况，并将研究结果与韧带各亚区域已知的力学特性相关联。
将6条新鲜尸体的舟月骨间韧带分为3个亚区域：背侧、掌侧和近端。使用标准苏木精-伊红染色以及针对S-100、神经丝、神经元特异性烯醇化酶、蛋白基因产物9.5、CD31和平滑肌肌动蛋白的免疫染色来研究微观特征。研究结缔组织结构组成以及血管和神经结构（有髓和无髓神经纤维以及机械感受器）的存在情况。还记录了宏观解剖细节。
掌侧亚区域核心为结构规整、胶原化致密的组织，周围是较疏松的结缔组织。形成束状的有髓神经纤维伴随韧带实质内散在的血管。它们在掌侧亚区域近端部分的浓度更高，距韧带游离面约150μm处达到峰值。背侧亚区域结构与掌侧相似，但纤维组织比例和密度更高。近端亚区域核心由软骨样基质和疏松结缔组织组成。在近端亚区域掌侧可见桡舟月韧带附着。帕西尼小体和其他感觉小体大多见于掌侧和近端亚区域。
舟月骨间韧带是神经丰富的韧带，有助于腕关节本体感觉，这是动态腕关节稳定性的基本要素。掌侧亚区域除了其主要力学作用外，还含有最多的神经结构和机械感受器。背侧亚区域胶原纤维密集排列且神经支配有限，主要功能是限制舟月骨相对运动。
