Korstanje Jan-Wiebe H, Schreuders Ton R, van der Sijde Jors, Hovius Steven E R, Bosch Johan G, Selles Ruud W
Department of Rehabilitation Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
J Hand Surg Am. 2010 Apr;35(4):559-65. doi: 10.1016/j.jhsa.2010.01.010. Epub 2010 Mar 12.
Cadaver and in vivo studies report variable results for tendon excursion during active and passive hand movements. The purpose of this study was to measure long finger flexor digitorum profundus (FDP) tendon excursion during active and passive movement using high-resolution ultrasound images.
The FDP tendon excursion was measured at the wrist level in 10 healthy subjects during full tip-to-palm active and passive flexion of the fingers. Passive movement was performed 2 ways: (1) straight to full fist: passive flexion starting at the metacarpophalangeal joint, followed by proximal interphalangeal and distal interphalangeal joint flexion; and (2) hook to full fist: passive flexion starting at the distal interphalangeal joint, followed by proximal interphalangeal and metacarpophalangeal joint flexion. Tendon excursion was measured using an in-house-developed, frame-to-frame analysis of high-resolution ultrasound images.
Median FDP excursion was 24.3 mm, 14.0 mm, and 13.6 mm for active fist, straight to full fist, and hook to full fist movements, respectively. Tendon excursions during active movements was significantly larger than excursions during passive movements (p = .005). The adjusted median tendon excursion was 12.7 mm/100 degrees , 7.5 mm/100 degrees , and 7.4 mm/100 degrees for active fist, straight to full fist, and hook to full fist movements, respectively. Adjusted tendon excursions during active movement were significantly larger than those achieved during passive straight to full fist movement). Adjusted tendon excursions during straight to full fist movements were significantly larger than those achieved during passive hook to full fist movement.
Active motion produced 74% and 79% increases in excursions compared to both passive motions in healthy controls. The study results can serve as a reference for evaluating excursions in patients with tendon pathology, including those who have had tendon repair and reconstruction.
尸体研究和体内研究报告了主动和被动手部运动期间肌腱移动的不同结果。本研究的目的是使用高分辨率超声图像测量主动和被动运动期间示指、中指、环指和小指的指深屈肌腱（FDP）移动情况。
在10名健康受试者手指从完全指尖到手掌的主动和被动屈曲过程中，于腕部水平测量FDP肌腱移动情况。被动运动通过两种方式进行：（1）直接握拳：从掌指关节开始被动屈曲，随后近端指间关节和远端指间关节屈曲；（2）钩状握拳：从远端指间关节开始被动屈曲，随后近端指间关节和掌指关节屈曲。使用自行开发的高分辨率超声图像逐帧分析来测量肌腱移动情况。
主动握拳、直接握拳和钩状握拳动作时，FDP肌腱移动的中位数分别为24.3 mm、14.0 mm和13.6 mm。主动运动期间的肌腱移动明显大于被动运动期间的移动（p = 0.005）。主动握拳、直接握拳和钩状握拳动作时，调整后的肌腱移动中位数分别为12.7 mm/100度、7.5 mm/100度和7.4 mm/100度。主动运动期间调整后的肌腱移动明显大于被动直接握拳运动时的移动。直接握拳运动期间调整后的肌腱移动明显大于被动钩状握拳运动时的移动。
在健康对照中，与两种被动运动相比，主动运动使肌腱移动增加了74%和79%。研究结果可为评估肌腱病变患者（包括接受肌腱修复和重建的患者）的肌腱移动提供参考。
