指背腱膜滑动与近侧指间关节屈曲关系及临床意义

Clinical meaning and the relationship between the slide of the dorsal digital aponeurosis and the flexion of the PIP

目的:探讨指背腱膜滑动距离与近侧指间关节(PIP)屈曲关系,为临床修复提供解剖学基础。方法:男性成人新鲜尸体标本10侧30指(示、中、环指各10指),切除手指皮肤,不破坏腱鞘、屈肌支持带、伸肌支持带、内在肌及外在肌,使肌腱保持正常的生理状态,分别测量各指中央束(CS)、侧束(LB)在PIP屈曲45°和90°时的滑动距离。结果:当PIP屈曲45°时,CS滑动距离为(2.7±0.4)mm,LB滑动距离为(2.8±0.6)mm;当PIP屈曲90°时,CS滑动距离为(4.3±0.7)mm,LB滑动距离为(4.8±0.6)mm。结论:指背腱膜滑动距离减少,严重影响手指的屈曲功能。对于指背腱膜的新鲜性损伤应予以精确修复;对于陈旧性损伤的修复应确保指背腱膜的正常滑动范围。

Objective: To discuss the relationship between the slide distance of the dorsal digital aponeurosis and the flexion of the PIP and provide anatomic basis for clinical repair. Methods: 30 specimens of finger (index, middle, ring) from 10 fresh male cadavers were observed. The skin of which was excised but the sheath, flexor and extensor retinaculum, intrinsic and extrinsic muscles were kept in physiological conditions. The slide distance of central slip (CS) and lateral band (LB) of fingers were measured when the flexion of PIP was at the angles of 45° and 90°. Results: The slide distance of the CS and LB was 2.67±0.44 mm, 2.83 ±0.56 mm respectively when the flexion of PIP was at the angle of 45°; the distance of CS and LB was 4.25 ±0.74 mm, 4.79 ±0.62 mm at the flexion angle of 90°. Conclusions: The decrease of the slide distance of the dorsal digital aponeurosis will influence flexion function of fingers. Fresh injury of the dorsal digital aponeurosis must be repaired accurately; and the normal slide range of the dorsal digital aponeurosis should be ensured for the repair of old lesion.