Yammine Kaissar
The Foot & Hand Clinic and The Center for Evidence-based Anatomy, Jdeideh Highway, Beirut, Lebanon.
Lebanese American University Medical Center-Rizk Hospital, Achrafieh, Lebanon.
Anat Rec (Hoboken). 2018 Jun;301(6):1046-1060. doi: 10.1002/ar.23774. Epub 2018 Jan 31.
Digital sesamoids are found in the metapodial-phalangeal joints of most mammals and quadrupedal tetrapods, yet their functional significance is still unclear. During primate evolution, a slight decline in their frequency has been associated with brachiation in gibbons, followed by a quasi-complete absence in orangutans then a slight resurgence occurred in gorillas and chimpanzees. Simultaneously, forearm muscles showed a progressive division in hominoid evolution towards a more "individualistic" musculature yielding more mobility and independence to some fingers. In humans, sesamoids are consistently observed in thumbs and big toes and frequently in other hypermobile digits such as the index and little fingers. Using a simple mathematical equation, this paper attempted to quantify a presumed association between hypermobile fingers and sesamoid frequency and distribution in humans. To this, an anatomic definition of digital independence has been formulated which includes three variables; (1) number and (2) frequency of independent flexor/extensor forearm muscles destined to a single finger, (3) and number of free/absent webspace. Results of previous meta-analyses and means of big sample studies were used to evaluate the frequency of such muscles. The expected values obtained via this model were found to be very close to the observed (published) values of the ossified sesamoids in human hands, and that in terms of frequency and distribution. The findings in humans showed a quasi-linear association between the degree of mobility and sesamoid frequency. The more the number of independent muscles destined to a finger, the more its metacarpo-phalangeal joint is likely to bear sesamoids. Based on our results and on a new analysis of primates' forearm/hand muscles and sesamoid evolution, a new hypothesis is proposed to answer two questions; the evolution of digital sesamoid frequency in primates and its sesamoid distribution in human digits. It claims that the number/frequency of independent forearm/hand muscles, and particularly the independent extensors, is likely to be a major factor in sesamoid reversion in hominoids. The argument is based on the link between the metatarsal break induced by the digitigrade locomotion observed in quadrupedal mammals and tetrapods and the amount of extra-extension of the metacarpo-phalangeal joints conferred by the individualization of some forearm extensors. The same rationale yielded similar conclusions when applied to both the hand and foot. The manipulative function of the hand and the plantigrade locomotion of the foot required such extra-extension in specific digits and consequently, a higher frequency of digital sesamoids was associated with these two different functions. The new evolutionary analysis suggests evolutionary pathways for both, the sesamoids of the hands and feet, and speculates that muscle individualization would have induced a very slow re-acquisition of digital sesamoids when compared to their rapid decline after brachiation. It is the first hypothesis offering a plausible explication on the recent evolution of digital sesamoids; specifically, the progression of sesamoid frequency in African apes and its resurgence, prevalence and distribution in humans. Anat Rec, 301:1046-1060, 2018. © 2018 Wiley Periodicals, Inc.
在大多数哺乳动物和四足类四足动物的掌指关节中都能发现籽骨,但它们的功能意义仍不明确。在灵长类动物的进化过程中,其出现频率略有下降,这与长臂猿的臂行有关,随后在猩猩中几乎完全消失,而在大猩猩和黑猩猩中又略有回升。同时,在类人猿的进化过程中,前臂肌肉逐渐分化,形成了更“个体化”的肌肉组织,使一些手指具有更大的灵活性和独立性。在人类中,籽骨在拇指和大脚趾中始终存在,在其他活动度较大的手指(如食指和小指)中也经常出现。本文试图通过一个简单的数学方程,量化人类活动度较大的手指与籽骨频率和分布之间的假定关联。为此,制定了一个手指独立性的解剖学定义,其中包括三个变量:(1)支配单个手指的独立屈/伸前臂肌肉的数量和(2)频率,(3)游离/缺失的指蹼空间数量。利用先前荟萃分析的结果和大样本研究的均值来评估此类肌肉的频率。通过该模型获得的预期值在频率和分布方面与人类手部已骨化籽骨的观察(已发表)值非常接近。人类的研究结果表明,活动度与籽骨频率之间存在近似线性的关联。支配一个手指的独立肌肉数量越多,其掌指关节就越有可能有籽骨。基于我们的研究结果以及对灵长类动物前臂/手部肌肉和籽骨进化的新分析,提出了一个新的假设,以回答两个问题:灵长类动物中籽骨频率的进化以及其在人类手指中的籽骨分布。该假设认为,独立的前臂/手部肌肉的数量/频率,尤其是独立的伸肌,可能是类人猿中籽骨逆转的主要因素。这一论点基于在四足哺乳动物和四足动物中观察到的趾行运动导致的跖骨骨折与一些前臂伸肌个体化赋予掌指关节的额外伸展量之间的联系。将同样的原理应用于手和脚时得出了类似的结论。手的操作功能和脚的跖行运动需要特定手指有这种额外的伸展,因此,较高频率的手指籽骨与这两种不同的功能相关。新的进化分析提出了手和脚籽骨的进化途径,并推测与臂行后籽骨的迅速减少相比,肌肉个体化会导致籽骨非常缓慢地重新出现。这是第一个对手指籽骨近期进化提出合理解释的假设;具体来说,是非洲猿类中籽骨频率的变化及其在人类中的重新出现、普遍性和分布。《解剖学记录》,301:1046 - 1060,2018。© 2018威利期刊公司。