Schmidt H M, Lahl J
Anatomischen Institut der Universität Würzburg.
Gegenbaurs Morphol Jahrb. 1988;134(2):155-73.
In 47 dissected right and left hands of adults of both sexes, kept in a moist condition, significant practical-clinical investigations of the transitional zone between forearm and hand were undertaken. In particular it was sought to determine the characteristic sizes of the extensor retinaculum, the osteofibrous tunnels, the insertion tendons of the hand and finger extensor muscles, and their tendon sheaths. Together with the palmar carpal ligament, the 2 to 3 cm wide extensor retinaculum annularly surrounds the whole circumference of the carpus. It extends obliquely from radial-proximal to ulnar-distal and conducts the extensor tendons over the carpal articulations. According to recent studies, it is divided into a superficial and a deep fibrous layer. From the undermost surface, vertical and oblique septa run to the plane of the forearm and carpal bones. They separate the fibrous portion of the 6 tendinous compartments of the dorsum manus. In 8.5% of cases, an accessory and completely independent tunnel of the extensor pollicis brevis muscle exists in the material investigated, and in 2.2% of cases, there is an additional tunnel for the extensor carpi radialis muscle. Hence, one occasionally finds 8 separate osteofibrous gliding compartments for the extensor muscles in the dorsal hand region. The longest tunnel belongs, as a rule, to the extensor digiti minimi muscle, whilst the widest pertains to the extensor digitorum muscle. Within the tunnel and also proximal and distal to it, the extensor tendons are surrounded by synovial sheaths. Because of its wide encroachment on the dorsum of the hand, the insertion tendon of the extensor digiti minimi muscle possesses the longest tendon sheath, measuring 68.8 mm. The next longest sheath, that of the extensor pollicis longus muscle, which measures 56.2 mm, begins further proximal to the gap of the radiocarpal articulation. In 12.8% of cases, there are divided sheaths of the abductor pollicis longus and of the extensor pollicis brevis muscle. The tendon sheath of both extensor carpi radiales muscles is frequently divided into 2 compartments which, in 2/3 of cases, communicate. The compartment of the extensor carpi radialis brevis muscle, in 91.5% of cases, shares a window-like opening with the roof of the synovial vagina of the extensor pollicis longus muscle. The tendon sheath of the long extensor muscles of the fingers originates 5 mm proximal to the forearm border of the extensor retinaculum and has a communal recess. The IVth tendon sheath opens distally and splays out in a glove-like manner to some distal recesses.(ABSTRACT TRUNCATED AT 400 WORDS)
在47具成年男女已解剖的左右手中（保持湿润状态），对前臂与手部之间的过渡区域进行了重要的实践临床研究。特别旨在确定伸肌支持带、骨纤维隧道、手部和手指伸肌的止点肌腱及其腱鞘的特征尺寸。伸肌支持带宽2至3厘米，与腕掌侧韧带一起环形围绕腕骨的整个圆周。它从桡侧近端向尺侧远端倾斜延伸，并引导伸肌腱越过腕关节。根据最近的研究，它分为浅、深两层纤维。从最下面的表面，垂直和斜向的间隔延伸至前臂和腕骨平面。它们将手背6个腱间隔的纤维部分分开。在所研究的材料中，8.5%的病例存在拇短伸肌的副独立隧道，2.2%的病例存在桡侧腕伸肌的额外隧道。因此，在手背区域偶尔会发现伸肌的8个独立骨纤维滑动间隔。通常，最长的隧道属于小指伸肌，而最宽的属于指伸肌。在隧道内及其近端和远端，伸肌腱被滑膜鞘包围。由于小指伸肌的止点肌腱对手背侵犯范围广，其腱鞘最长，为68.8毫米。次长的腱鞘是拇长伸肌的腱鞘，长56.2毫米，起始于桡腕关节间隙的近端。12.8%的病例中，拇长展肌和拇短伸肌的腱鞘是分开的。两块桡侧腕伸肌的腱鞘常分为两个间隔，其中2/3的病例两者相通。桡侧腕短伸肌的间隔在91.5%的病例中与拇长伸肌滑膜鞘顶部有一个窗形开口。手指长伸肌的腱鞘起始于伸肌支持带前臂边界近端5毫米处，并有一个共同的隐窝。第4腱鞘向远端开放，并呈手套状展开至一些远端隐窝。（摘要截断于400字）
