Wang Keming, McGlinn Evan P, Chung Kevin C
17th Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; Section of Plastic Surgery, University of Michigan Health System, Ann Arbor, MI.
17th Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; Section of Plastic Surgery, University of Michigan Health System, Ann Arbor, MI.
J Hand Surg Am. 2014 Jan;39(1):149-55. doi: 10.1016/j.jhsa.2013.06.029.
The lumbrical muscles of the hand originate from the flexor digitorum profundus tendons and insert onto the lateral band of the extensor tendons. Owing to these movable attachments, the function of this muscle is difficult to visualize. To better determine the function of this muscle, we considered its relative anatomy, biomechanical characteristics, and evolution. With the smallest physiological cross-sectional area in the upper extremity, the lumbrical muscles have weak motor function, which is only 1/10 of the interosseous muscle. Because they are spindle rich, the lumbrical muscles play an important role in the sensory feedback of the distal interphalangeal, proximal interphalangeal, and metacarpophalangeal joints of the fingers. The first 2 lumbrical muscles have lower variation in anatomy and higher density of muscle spindles compared to the ulnar 2 lumbricals. In addition, the index and middle finger lumbrical muscles are innervated by the median nerve, which also innervates the thenar muscles of the thumb. Therefore, it is possible that the first 2 lumbricals are functionally more important than the 2 ulnar lumbricals, specifically for precision pinch movements.
手部的蚓状肌起自指深屈肌腱,止于伸肌腱的外侧束。由于这些可活动的附着点,该肌肉的功能难以直观呈现。为了更好地确定该肌肉的功能,我们考虑了其相关解剖结构、生物力学特性及进化情况。蚓状肌在上肢的生理横截面积最小,运动功能较弱,仅为骨间肌的1/10。由于富含梭形肌,蚓状肌在手指远侧指间关节、近侧指间关节和掌指关节的感觉反馈中起重要作用。与尺侧的2块蚓状肌相比,第1、2蚓状肌在解剖结构上变异较小,肌梭密度较高。此外,示指和中指的蚓状肌由正中神经支配,正中神经也支配拇指的鱼际肌。因此,前2块蚓状肌在功能上可能比尺侧的2块蚓状肌更重要,特别是对于精确捏取动作而言。