拇指伸肌腱宽度与拇短伸肌腱止点关系的研究  

Aanatomical study of the relationship between the extensor tendon width of the thumb and the distal insertion of the extensor pollicis brevis

作　　者：张玲西 李成 赵蓉 杨晓娟 杨晓霞 孟冰冰 毛庆花 李京 ZHANG Ling-xi;LI Cheng;ZHAO Rong;YANG Xiao-juan;YANG Xiao-xia;MENG Bingbing;MAO Qing-hua;LI Jing(Basic Academy of Jining Medical University,Jining,Shandong 272067,China)

机构地区：[1]济宁医学院 [2]济宁市第一人民医院新生儿科 [3]济宁医学院基础医学院

出　　处：《解剖学研究》2019年第2期140-142,150,共4页Anatomy Research

基　　金：济宁医学院2018年大学生创新训练计划项目(cx2018073)

摘　　要：目的测量拇指伸肌腱的宽度,并分析该宽度与拇短伸肌腱远端止点之间的关系。方法 76例(左侧39例,右侧37例)经10%福尔马林溶液灌注固定的人体上肢标本,解剖第1骨纤维管、拇长展肌、拇短伸肌以及拇长伸肌,观察纤维管内肌腱中隔分布情况;采用游标卡尺,测量拇指近节指骨背面中点处伸肌腱宽度,利用ROC曲线,分析该宽度与拇短伸肌腱远端止点之间的关系。结果①52例第1骨纤维管内出现肌腱中隔(68.4%);30例拇短伸肌腱止点发生延长,即越过拇指掌指关节;②拇短伸肌腱未延长组,伸肌腱宽度(6.04±0.92)mm;而延长组拇指伸肌腱的宽度(7.52±1.38)mm,显著高于未延长组(t=4.050,P=0.000);③通过测量拇指近节指背中点处伸肌腱宽度,判断拇短伸肌腱止点延长的情况:ROC曲线下面积0.823,临界值7.21 mm,灵敏度和特异度分别是0.843和0.927,正确率为90%。结论当拇短伸肌腱止点延长时,拇指近节指骨背面肌腱的宽度增加;此宽度不仅能够用来识别变异,对于拇指腱鞘炎的外科治疗,具有一定的指导意义。Objective To evaluate the relationship between the extensor tendon width and the point of distal insertion of the extensor pollicis brevis tendon(EPB). Methods 76 upper limbs(39 left sides,37 right sides)were perfused with 10% formalin solution perfusion. The first extensor compartment was dissected and the intertendinous septum was assessed. The extensor tendon width was measured at the midpoint of the proximal phalanx,and the relationships between extended EPB tendon,extensor tendon width were examined. Results ①The intertendinous septum and extended EPB tendon were observed in 68.4% and 39.5% cases,respectively.②The mean extensor tendon width in the extended EPB group(7.52±1.38 mm)was greater than in the normal EPB group(6.04±0.92 mm)(t=4.050,P=0.000).③The cut-off value of extensor tendon width was 7.21 mm in the extended EPB group,yielding a sensitivity of 0.843 and a specificity of 0.927.Conclusion The extensor tendon width was wider in the extended EPB group than in the normal group,which could be used to identify various anatomical variations in the extended EPB.

关 键 词：第1骨纤维管 拇短伸肌 拇长伸肌 止点 应用解剖 

分 类 号：R322.7[医药卫生—人体解剖和组织胚胎学]