小指对掌肌腱弓的解剖学研究

ANATOMICAL STUDY ON THE FASCIAL ARCH OF THE OPPONENS DIGITI MINIMI

目的探讨Guyon管以远尺神经深支卡压征的解剖学基础。方法对20例新鲜成人上肢标本腕部进行显微解剖,肉眼及镜下观测腕部尺神经分支与周围组织的关系。结果尺神经穿出Guyon管后进入小指对掌肌浅、深两头和钩骨钩之间的间隙,该间隙可分为顶、底和桡侧壁,有一个入口和一个出口,暂称其为小指对掌肌间隙。小指对掌肌浅头腱性起点的近侧缘锐利,呈腱弓样,存在率100%,暂称其为小指对掌肌腱弓。结论小指对掌肌腱弓可以卡压尺神经深支,引起除小鱼际肌以外的尺神经支配的所有手内在肌的功能障碍。

Objective To explore the entrapment to the deep branch of the ulnar nerve at the wrist, to assist the surgeon in diagnosis and treatment of Guyon canal syndrome. Methods Twenty fresh upper limbs were dissected on loupe （ × 5 ）, to record the relationship between the ulnar nerve and the hypothenar muscles, the course of the ulnar nerve at the wrist. Results The deep branchs of the ulnar nerve go through an intermuscular space after runing out of the Guyon canal. The intermuscular space consisits of the superficial and deep head of the opponens digiti minimi and the hook of the hamate, which has one entrance and one exit. We named the intermuscular space as the hiatus of opponens digiti minimi, and named the proximal edge of the superficial head of the opponens digiti minimi as the fascial arch of the opponens digiti minimi. Conclusion We found that the fascial arch of the opponens digiti minimi can compress the deep branch of the ulnar nerve causing motor deficit of the intrinsic muscles of hands.