手指伸肌腱Ⅰ区肌腱末节指骨止点与毗邻组织的应用解剖学研究  

Applied anatomy study of zoneⅠextensor terminal tendon insertion and its adjacent tissues

作　　者：赵文韬 赵民 Zhao Wentao;Zhao Min(Volgogard Medical University,Volgograd 400131,Russia;Department of Upper Limber Surgery,The Hospital of Shunyi District Beijing,Beijing 101300,China)

机构地区：[1]伏尔加格勒国立医科大学,俄罗斯400131 [2]北京市顺义区医院上肢外科,北京101300

出　　处：《中国临床解剖学杂志》2021年第2期126-129,共4页Chinese Journal of Clinical Anatomy

基　　金：北京市顺义区科技三项费项目(KS201932)。

摘　　要：目的通过对手指伸肌腱Ⅰ区肌腱末节指骨止点与毗邻组织的解剖研究,为骨性锤状指微型钢板内固定手术提供解剖依据。方法解剖观测10例成人尸体上肢手标本,观察指甲根部甲基质、甲根与伸肌腱Ⅰ区末节指骨止点的解剖关系,测量伸肌腱Ⅰ区末节指骨止点至甲根、甲基质、关节面距离,测量伸肌腱Ⅰ区末节指骨止点的宽度,测量末节指骨关节面水平的横径及纵径。显微镜下观察伸肌腱Ⅰ区末节指骨止点的形态及其与周围组织之间的联系。结果甲根近端未能完全覆盖甲基质,甲基质与伸肌腱Ⅰ区末节指骨止点相距(1.21±0.21)mm,两者之间平铺一层疏松结缔组织。伸肌腱Ⅰ区末节指骨止点宽度为(6.27±1.23)mm,在关节水平厚度为(1.02±0.21)mm。伸肌腱Ⅰ区末节指骨止点在肌腱掌侧面至末节指骨关节面(1.22±0.21)mm。末节指骨的关节面水平的横径为(8.00±2.21)mm,纵径为(6.22±1.21)mm。伸肌腱Ⅰ区与远侧指间背侧关节囊联系紧密,显微镜下解剖未见两者之间存在明显的解剖间隙。结论末节指骨背侧正中皮肤切口可充分显露伸肌腱Ⅰ区末节指骨止点周围组织结构;在应用微型钩状钢板固定骨性锤状指末节撕脱骨折块时,钢板远端与甲基质部分重叠,需要部分切开甲根及甲基质。伸肌腱Ⅰ区与远侧指间背侧关节囊联系紧密,该处伸肌腱终腱存在类似掌板样纤维软骨组织。Objective To provide anatomical basis for mini plate internal fixation of bony mallet finger by anatomical study of the zoneⅠterminal extensor tendon and adjacent tissues.Methods Ten adult hand cadavers’upper limb specimens were dissected and the anatomical relationships between nail matrix,nail root and zoneⅠterminal extensor tendon were observed.Microscopically,the distance from the terminal extensor tendon to nail root,nail matrix,articular surface were measured.The width of zoneⅠterminal extensor tendon and the transverse and vertical diameters of phalangette joints were measured.Results The proximal margin of the nail root did not completely cover the germinal matrix,and the distance between the zoneⅠterminal extensor tendon and the germinal matrix was(1.21±0.21)mm.There was a loose connective tissue between them.The width of terminal extensor tendon was(6.27±1.23)mm,horizontal thickness was(1.02±0.21)mm.The distance between the zoneⅠterminal extensor tendon and the articular of the distal interphalanx was(1.22±0.21)mm.The transverse diameter of the distal phalanx articular surface was(8.00±2.21)mm,the longitudinal diameter was(6.22±1.21)mm.ZoneⅠterminal extensor tendon was closely connected to the dorsal articular capsule of distal interphalangeal joint.Conclusions The longitudinal dorsal median skin incision on the distal phalangeal bone can fully reveal the tissue structure around zoneⅠterminal extensor tendon.In fixing the avulsed fracture fragment of the distal phalanx,the plate is partially overlapped with the nail matrix,and the nail root and nail matrix need to be partially incised.The terminal extensor tendon is closely linked to the dorsal capsule of distal interphalangeal joint,where the zoneⅠterminal extensor tendon has a dorsal fibrous cartilage tissue plate,just like the volar plate.

关 键 词：伸肌腱终腱 甲基质 骨性锤状指 应用解剖 远侧指间关节 

分 类 号：R323.71[医药卫生—人体解剖和组织胚胎学] R658.2[医药卫生—基础医学]