Fiorini Haroldo J, Santos João B G, Hirakawa Celso K, Sato Edson S, Faloppa Flávio, Albertoni Walter M
Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo, São Paulo, Brazil.
J Hand Surg Am. 2011 Mar;36(3):464-8. doi: 10.1016/j.jhsa.2010.11.045. Epub 2011 Jan 31.
The objectives of this study were to evaluate palmar surface parameters to identify the exact location of the proximal edge of the flexor tendon A1 pulley relative to the digital palmar crease of the index, middle, ring, and little fingers and to evaluate the length of this pulley.
We studied 280 fingers on 70 hands from 35 fresh human cadavers, initially by measuring the distance between the digital-palmar and proximal interphalangeal creases (measure A), followed by dissection of the fingers and measurement of the distance between the proximal edge of the A1 pulley and the digital-palmar crease (measure B) and the length of the A1 pulley (measure C). We carried out statistical analysis using Hotelling's multivariate T(2)-test and the paired-samples t-test.
We found no statistically significant difference between measures A and B in each finger (p > .05). The mean lengths, in tenths of millimeters, were as follows: measure A: index finger 22.0 mm, middle finger 24.4 mm, ring finger 22.0 mm, and little finger 17.9 mm; measure B: index finger 21.9 mm, middle finger 24.2 mm, ring finger 22.3 mm, and little finger 18.1 mm. The average lengths of the A1 pulley were: index finger 9.8 mm, middle finger 10.7 mm, ring finger 9.6 mm, and little finger 8.1 mm.
The distance between the digital-palmar and proximal interphalangeal creases may be used as a cutaneous landmark on the palmar surface for the exact location of the proximal edge of the A1 pulley in the palm of the hand, thereby ensuring greater safety in surgical procedures such as percutaneous release of trigger finger.
本研究的目的是评估手掌表面参数，以确定屈肌腱A1滑车近端边缘相对于示指、中指、环指和小指掌侧横纹的确切位置，并评估该滑车的长度。
我们对35具新鲜人体尸体的70只手的280根手指进行了研究，首先测量掌指横纹与近端指间横纹之间的距离（测量A），然后解剖手指并测量A1滑车近端边缘与掌指横纹之间的距离（测量B）以及A1滑车的长度（测量C）。我们使用Hotelling多元T(2)检验和配对样本t检验进行统计分析。
我们发现各手指测量A和测量B之间无统计学显著差异（p>.05）。平均长度（以十分之一毫米为单位）如下：测量A：示指22.0毫米，中指24.4毫米，环指22.0毫米，小指17.9毫米；测量B：示指21.9毫米，中指24.2毫米，环指22.3毫米，小指18.1毫米。A1滑车的平均长度为：示指9.8毫米，中指10.7毫米，环指9.6毫米，小指8.1毫米。
掌指横纹与近端指间横纹之间的距离可作为手掌表面的皮肤标志，用于确定手掌中A1滑车近端边缘的确切位置，从而在诸如经皮松解扳机指等手术过程中确保更高的安全性。
