Faculty of Medicine, Universitas Trisakti, Department of Orthopedic Surgery, St. Carolus Hospital, Jakarta, Indonesia; Department of Orthopedic Surgery, University of Ulsan, Asan Medical Center, Seoul, Korea.
Department of Orthopedic Surgery, University of Ulsan, Asan Medical Center, Seoul, Korea.
J Hand Surg Am. 2021 Nov;46(11):1029.e1-1029.e8. doi: 10.1016/j.jhsa.2021.03.002. Epub 2021 Apr 21.
To characterize and compare the histological structure of the proximal, central, and distal bands of the interosseous membrane (IOM) of the human forearm in fresh-frozen specimens.
The IOMs from 16 fresh-frozen left forearm specimens were carefully dissected and examined. The footprint areas of the proximal, central, and distal IOM bands were measured in 6 specimens. The histological characteristics of the IOM bands were evaluated using hematoxylin-eosin and Masson trichrome staining protocols in 10 specimens as histological analysis necessitated an intact footprint. The footprint areas of the IOM were measured using an image processing program. The insertion complex was assessed using a light microscope.
Histological assessment revealed that the IOM structure demonstrated similarities with ligament structure. The average footprint areas of the proximal, central, and distal bands at the radial site were 11.1 ± 0.8, 180.4 ± 30.4, and 10.7 ± 1.3 mm, respectively. At the ulnar site, they were 11.0 ± 1.1, 171.8 ± 30.1, and 10.7 ± 1.2 mm, respectively. The insertion complex of the IOM into the bone comprised 4 layers: (1) interwoven collagen, (2) oblique collagen, (3) mineralized fibrocartilage (tidemark), and (4) lamellar bone. The average tidemark zone thicknesses of the proximal, central, and distal bands were 20.1 ± 6.3, 107.8 ± 22.9, and 20.6 ± 4.7 μm, respectively at the radial site and 12.0 ± 4.5, 85.7 ± 23.2, and 13.5 ± 6.9 μm, respectively at the ulnar site.
In this study, we confirm that the histological characteristics of the IOM are similar to those of ligaments. Compared with the proximal and distal bands, the central band has a greater footprint area and thicker tidemark zone.
If surgical reconstruction is performed, the size and histological characteristics of the graft should be similar to those of the native ligaments.
在新鲜冷冻标本中对人体前臂骨间膜（IOM）的近侧、中央和远侧带的组织学结构进行特征描述和比较。
仔细解剖和检查了 16 个新鲜冷冻的左手前臂标本的 IOM。在 6 个标本中测量了 IOM 近侧、中央和远侧带的足迹面积。在 10 个标本中使用苏木精-伊红和 Masson 三色染色方案评估 IOM 带的组织学特征，因为组织学分析需要完整的足迹。使用图像处理程序测量 IOM 的足迹面积。使用光学显微镜评估插入复合体。
组织学评估表明，IOM 结构与韧带结构具有相似性。桡骨侧近侧、中央和远侧带的平均足迹面积分别为 11.1±0.8、180.4±30.4 和 10.7±1.3mm，尺骨侧分别为 11.0±1.1、171.8±30.1 和 10.7±1.2mm。IOM 插入骨的插入复合体包括 4 层：（1）交织的胶原，（2）斜胶原，（3）矿化纤维软骨（边界层）和（4）板层骨。桡骨侧近侧、中央和远侧带的平均边界层厚度分别为 20.1±6.3、107.8±22.9 和 20.6±4.7μm，尺骨侧分别为 12.0±4.5、85.7±23.2 和 13.5±6.9μm。
在这项研究中，我们证实 IOM 的组织学特征与韧带相似。与近侧和远侧带相比，中央带具有更大的足迹面积和更厚的边界层。
如果进行手术重建，移植物的大小和组织学特征应与天然韧带相似。
