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示指固有伸肌及其变异与手部指短伸肌:一种常见分类。在手外科和重建手术中的临床意义。

Extensor indicis proprius muscle and its variants together with the extensor digitorum brevis manus muscle: a common classification. Clinical significance in hand and reconstructive surgery.

作者信息

Georgiev Georgi P, Tubbs R Shane, Iliev Alexandar, Kotov Georgi, Landzhov Boycho

机构信息

Department of Orthopaedics and Traumatology, University Hospital Queen Giovanna-ISUL, Medical University of Sofia, 8 Bialo more str., 1527, Sofia, Bulgaria.

Seattle Science Foundation and Department of Anatomy, St. George's University, True Blue, Grenada.

出版信息

Surg Radiol Anat. 2018 Mar;40(3):271-280. doi: 10.1007/s00276-018-1981-9. Epub 2018 Jan 30.

Abstract

PURPOSE

The extensor indicis proprius (EIP) is a muscle of the forearm that originates from the posterior surface of the ulna and the adjacent interosseous membrane and attaches to the index finger. Many anatomical variations of this muscle have been reported in the literature. The extensor digitorum brevis manus (EDBM) is a variant muscle found on the back of the wrist and hand. These muscle variants should be considered in the context of clinical syndromes and reconstructive hand surgery. The aim of the present study was to describe in detail the normal and variant anatomy of these muscles and propose new systematic classifications.

MATERIALS AND METHODS

Formol-carbol-fixed Europid upper limbs (n = 176) were examined in the Department of Anatomy, Histology and Embryology at the Medical University of Sofia for variations of the EIP and occurrences of the EDBM.

RESULTS

We found normal anatomy in 147 (84%) of the specimens examined and we measured the length and width of the muscle belly and tendon of the EIP. Variations of the EIP in the other 29 upper limbs (16%) included replacement of the EIP by an EIB, coexistence of the EIP and EIB, presence of accessory tendons, and additional muscles.

CONCLUSIONS

Knowledge of anatomical variations of forearm muscles is important because they can cause clinical syndromes or have implications for reconstructive surgery, most often as tendon transfers in response to functional loss of other forearm muscles.

摘要

目的

示指固有伸肌(EIP)是前臂的一块肌肉,起自尺骨后表面及相邻的骨间膜,附着于示指。文献中已报道了该肌肉的许多解剖变异情况。手部指短伸肌(EDBM)是在腕背部和手部发现的变异肌肉。在临床综合征和手部重建手术的背景下应考虑这些肌肉变异。本研究的目的是详细描述这些肌肉的正常和变异解剖结构,并提出新的系统分类。

材料与方法

在索菲亚医科大学解剖学、组织学与胚胎学系检查了176例经甲醛 - 石炭酸固定的欧洲人上肢标本,以观察EIP的变异和EDBM的出现情况。

结果

在147例(84%)检查的标本中发现了正常解剖结构,并测量了EIP肌腹和肌腱的长度与宽度。在其他29例(16%)上肢中,EIP的变异包括被示指伸肌(EIB)替代、EIP与EIB共存、存在副腱以及额外的肌肉。

结论

了解前臂肌肉的解剖变异很重要,因为它们可能导致临床综合征或对重建手术有影响,最常见的是作为对其他前臂肌肉功能丧失的肌腱转移。

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