von Schroeder H P, Botte M J
Sunnybrook Health Sciences Center, Toronto, Ontario, Canada.
Hand Clin. 1997 Feb;13(1):51-62.
The complexity and intricacy of hand function are reflected by the anatomy. Extensor muscles have a relatively consistent architecture but also have notable anatomic variations of their tendons, particularly on the ulnar side of the hand. The extensor tendons, juncturae tendinum, intertendinous fascia, and soft tissue function as a plexiform construct to provide stability during power grip and allow for laxity in performing independent fine finger tasks. The greater independence of index finger motion relates to its two tendons, one (EDC-index) with a thin transverse juncturae tendinum, the other (EIP) without a junctural connection. It is also more independent because of a more mobile metatarsal, and because it is confined by only one web. The first dorsal interosseous also functions to rotate the index finger. The lumbrical to the index finger has only a single origin on the flexor profundus tendon. The elaborate tendon plexus on the dorsum of the hand is repeated in the complexity of the dorsal aponeurosis on the dorsum of the fingers. Finger motion is a balance of flexor muscles and intrinsics and extensor muscles that provides incredible versatility. This versatility and delicate balance of function is easily jeopardized by trauma and disease. The hand is among the most frequently injured parts of the body. An appreciation and understanding of its complex anatomy is of importance to hand assessment, repair, and reconstruction.
手部功能的复杂性和精细程度通过其解剖结构得以体现。伸肌具有相对一致的结构，但肌腱也存在显著的解剖变异，尤其是在手部的尺侧。伸肌腱、腱间结合、腱间筋膜和软组织共同构成一个丛状结构，在强力抓握时提供稳定性，并在进行独立的精细手指动作时允许一定程度的松弛。食指运动的独立性更强，这与其两条肌腱有关，一条（食指指总伸肌）有一条较细的横向腱间结合，另一条（食指固有伸肌）没有腱间连接。食指也因其掌骨更灵活，且仅受一个指蹼的限制而更加独立。第一背侧骨间肌还起到使食指旋转的作用。食指的蚓状肌仅在指深屈肌腱上有单一的起点。手部背侧复杂的肌腱丛在手指背侧的背侧腱膜的复杂性中再次体现。手指运动是屈肌、内在肌和伸肌之间的平衡，赋予了手部令人难以置信的多功能性。这种多功能性和微妙的功能平衡很容易因创伤和疾病而受到损害。手是身体最常受伤的部位之一。了解和认识其复杂的解剖结构对于手部评估、修复和重建至关重要。
