Van Sint Jan S, Rooze M, Van Audekerke J, Vico L
Department for Human Anatomy and Embryology, University of Brussels, Belgium.
J Hand Surg Am. 1996 Jan;21(1):69-76. doi: 10.1016/S0363-5023(96)80156-0.
Review of the literature reveals that the relationship between the extensor digitorum muscle tendon to the proximal phalanx and the metacarpophalangeal joint capsule remains unclear. The present study presents data about these relationships and consists of three parts: dissection of the region, high-gradient magnetic resonance imaging, and functional study. A total of 50 hands were used. Dissection was performed on 30, magnetic resonance studies were performed on 10, and the remaining 10 hands were used for the functional analysis. Dissection did not reveal an insertion of the extensor digitorum tendon on the base of the proximal phalanx. An extension of the dorsal part of the metacarpophalangeal joint capsule running proximally toward the palmar side of the extensor tendon was observed in eight hands. In the remaining 22 hands, only loose connective tissue was found between the articular capsule and the tendon. The development of this tissue was variable. These observations were correlated using a 7T magnetic resonance installation. The results of the functional study showed that hyperextension of the proximal phalanx increased after resection of the metacarpophalangeal structures lying under the extensor tendon. In conclusion, no real tendinous insertion of the extensor digitorum tendon on the base of the proximal phalanx could be found. Loose connective tissue was observed between the metacarpophalangeal joint capsule and the palmar aspect of the tendon, which seemed to play a secondary role in the extension of the proximal phalanx.
文献回顾显示，指伸肌肌腱与近节指骨以及掌指关节囊之间的关系仍不明确。本研究展示了有关这些关系的数据，共包括三个部分：该区域的解剖、高梯度磁共振成像以及功能研究。总共使用了50只手。对30只手进行了解剖，对10只手进行了磁共振研究，其余10只手用于功能分析。解剖未发现指伸肌肌腱在近节指骨基部的附着。在8只手中观察到掌指关节囊背侧部分向近端延伸至伸肌腱掌侧。在其余22只手中，关节囊与肌腱之间仅发现疏松结缔组织。该组织的发育情况各异。使用7T磁共振设备对这些观察结果进行了关联分析。功能研究结果表明，切除伸肌腱下方的掌指结构后，近节指骨的过伸增加。总之，未发现指伸肌肌腱在近节指骨基部有真正的腱性附着。在掌指关节囊与肌腱掌侧之间观察到疏松结缔组织，其在近节指骨伸展中似乎起次要作用。
