人前臂多肌腱肌肉的形态特点、神经分布及肌内腱板特征

Morphological features, nerve supply and characteristics of intramuscular tendinous laminae of multitendoned muscles in human forearm

目的：观察人前臂多肌腱肌肉的形态特点、神经分布及其横断面内肌内腱板或纤维隔的特征，探讨其在手指运动中的作用。方法：在SXP-1C型手术显微镜下，解剖、观察前臂多肌腱肌肉的神经分支来源、分布及其横断面内的肌内间隔。结果：前臂多肌腱肌肉在起始处与毗邻肌肉的肌腹相结合，远侧分为4个相对独立的肌束，并逐渐移行至第2～5指肌腱。4个肌束之间分界不清，但至示指肌束相对独立。支配多肌腱肌肉的神经主干通常超过4支，并在不同部位穿人肌束。多肌腱肌肉的横断面显示，肌腹内存在不完全分隔4个肌束的肌内腱板或纤维隔。结论：前臂多肌腱肌肉的形态、神经分布及其内肌内腱板或纤维隔状况与第2～5指独立运动的局限性相关，肘前区和前臂近侧的手术应注意避免损伤正中神经至前臂的分支。

Objective： To discuss the role of multitendoned muscles in human forearm in the movement of 2-5 fingers by observing their morphological features, nerve supply and the arrangement of the intramuscular tendinous laminae or fibrous septa. Methods： Dissecting and observing the nervous origin, the arrangement and intramuscular septa in the transverse sections in multitendoned muscles in the human forearm with aid of SXP-1C operating microscope. Results： The muscle bellies of multitendoned muscles were fused with those of the adjacent muscles at the origin and distally separated into 4 relatively independent muscle bundles. The muscle bundles tapered distally and were continuous with the tendons which were inserted on 2-5 fingers. No obvious demarcation lay among these muscle hundles, while the muscle bundle to the index finger was more independent. Usually more than 4 main nerve trunks innervated each multitendoned muscle and entered into the muscle at the different sites. The sections of multitendoned muscles showed that the incomplete intramuscular tendinous laminae or fibrous septa existed in them. Conclusion： The morphological features, nerve supply and the existence of the incomplete intramuscular tendinous laminae or fibrous septa in multitendoned muscles in the human forearm are correlated with the limitation of independent movement of 2-5 fingers. Surgeons should pay attention to the branches of median nerve to forearm when performing the operation on the anterior cubital region and proximal part of the forearm.