目的:关于长指掌指关节的详尽文献,但是,覆盖骨间肌肉并连接长手指掌骨头的背侧韧带结构仍有待充分表征。以前,我们的外科手团队观察到一个非经典报道的结构,连接长手指的掌骨头,在掌骨间隙的背侧。因此,这项解剖学研究的目的是在大小方面表征这种韧带结构,插入,解剖位置。
方法:解剖25只手,共75只长手指掌骨间隙。细胞组织切除和背侧浅筋膜开放后露出韧带结构。测量长度和厚度,并研究解剖位置和插入。对五个标本进行组织学分析,并对一名健康受试者进行超声分析。
结果:所有25个解剖显示背侧韧带结构,以下命名为掌骨远端背侧韧带,插入每个相邻长手指掌骨头的侧结节中。掌骨远端背侧韧带包围了骨间肌腱。与斜肌和横向骨间肌纤维相比,它更近。组织学分析证实了该结构的韧带性质。超声分析表明,该结构在手的背侧下得到了很好的识别。
结论:所有解剖都显示长指的每个掌骨头之间有一个紧张的韧带结构。这是一个恒定的结构,符合韧带的定义。掌骨远端背侧韧带似乎通过限制过度外展来稳定第二和第四空间的掌骨头。
OBJECTIVE: Exhaustive literature is available on the metacarpophalangeal joints of the long fingers, but the dorsal ligamentous structure overlaying the interosseous muscles and joining the metacarpal heads of the long fingers remains to be fully characterized. Previously, our surgical hand team observed a non-classically reported structure connecting the metacarpal heads of the long fingers, in the dorsal part of the intermetacarpal spaces. Therefore, the aim of this anatomical study was to characterize this ligamentous structure in terms of size, insertions, and anatomical position.
METHODS: Twenty-five hands were dissected for a total of 75 long finger intermetacarpal spaces. A ligamentous structure was exposed after cellular tissue excision and dorsal superficial fascia opening. The length and thickness were measured and anatomical position and insertions were studied. Histological analysis was performed on five specimens and ultrasound analysis in one healthy subject.
RESULTS: All 25 dissections revealed a dorsal ligamentous structure, hereafter named distal dorsal intermetacarpal ligament, which was inserted in the lateral tubercle of each adjacent long finger metacarpal head. This distal dorsal intermetacarpal ligament surrounded interosseous tendons. It was more proximal compared to oblique and transversal interosseous muscle fibers. Histological analysis confirmed the ligamentous nature of the structure. Ultrasound analysis showed that this structure was well identified under the dorsal aspect of the hand.
CONCLUSIONS: All dissections revealed a tense ligamentous structure between each metacarpal head of the long fingers. This was a constant structure meeting the definition of a ligament. The distal dorsal intermetacarpal ligament seems to stabilize the metacarpal heads at the second and fourth spaces by limiting hyperabduction.