Srinivasan H, Landsmeer J M
J Hand Surg Am. 1982 Jul;7(4):371-5. doi: 10.1016/s0363-5023(82)80146-9.
An analysis of the thumb as an articular chain, with the biarticular tendon displacement used as a model, is presented. Comparison of the extensor pollicis longus/flexor pollicis longus (EPL/FPL) tendon displacement ratios at the three joints, as determined from cadaver studies, shows that the thumb will be unstable, with a persistent tendency to extend at the carpometacarpal (CMC) joint and flex at the interphalangeal (IP) joint when it is under the exclusive control of the EPL and FPL muscles. In addition, according to the model, with stabilization of the CMC joint, the MCP joint will tend to extend and the IP joint will flex. Clinical data from thumbs of leprosy patients with thenar paralyses largely confirm these predictions and the validity of this approach in studying the functional behavior of the thumb.
本文提出了以双关节肌腱移位为模型，对拇指作为一个关节链进行分析。根据尸体研究确定的三个关节处拇长伸肌/拇长屈肌（EPL/FPL）肌腱移位比率的比较表明，当拇指仅受EPL和FPL肌肉控制时，拇指会不稳定，在腕掌关节（CMC）有持续伸展的趋势，而在指间关节（IP）有屈曲的趋势。此外，根据该模型，随着CMC关节的稳定，掌指关节（MCP）会趋于伸展，而IP关节会屈曲。来自患有大鱼际肌麻痹的麻风病患者拇指的临床数据在很大程度上证实了这些预测以及该方法在研究拇指功能行为方面的有效性。
