拇短展肌对拇指指骨间关节背伸作用的解剖学研究

发布时间：2018-08-24 18:45

【摘要】：目的为解决胸小肌移植重建拇对掌功能术后出现拇指指骨间关节屈曲畸形提供解剖学依据并寻找解决办法。方法在15具尸体手标本上,使拇指处于对掌位时,测量拇指指骨间关节在拇短展肌未切断及切断两种情况下的自然屈曲角度;同时,通过外力作用使拇指指骨间关节分别屈曲处于45°及60°时,分析拇短展肌对拇指指骨间关节屈伸功能的影响。结果拇指处于对掌位时,拇短展肌在未切断及切断两种情况下,拇指指骨间关节自然屈曲角度分别为(13.30±2.13)°及(24.03±1.25)°;同时,使拇指指骨间关节屈曲处于45°时,所用外力分别约(0.50±0.08)N及(0.22±0.07)N,而使拇指指骨间关节屈曲处于60°时,所用外力分别约(1.48±0.09)N及(1.15±0.04)N。结论拇短展肌对拇指指骨间关节主要起背伸作用,因此胸小肌移植重建拇对掌功能时,应同时重建拇短展肌功能,才有可能纠正在拇对掌功能重建术后出现的拇指指骨间关节屈曲畸形。
[Abstract]:Objective to provide anatomical basis for solving the flexion deformity of interosseous joint of thumb and phalanx after reconstruction of thumb and palmar function with pectoralis minor muscle transplantation and to find a solution. Methods the natural flexion angle of the interphalangeal joint of the thumb was measured in 15 cadaveric hand specimens when the thumb was in the opposite position, and the flexion angle of the interphalangeal joint of the thumb was measured under the condition of not cutting off and cutting off the abductor pollicis brevis muscle. The effect of abductor pollicis brevis on the flexion and extension of the interphalangeal joint of the thumb was analyzed when the flexion of the interphalangeal joint of the thumb was at 45 掳and 60 掳respectively by external force. Results the natural flexion angles of the interphalangeal joint of the thumb were (13.30 卤2.13) 掳and (24.03 卤1.25) 掳respectively when the thumb was in the opposite metacarpal position, and when the flexion of the interphalangeal joint of the thumb was 45 掳, the flexion angle of the interphalangeal joint of the thumb was (13.30 卤2.13) 掳and (24.03 卤1.25) 掳, respectively. The external forces were about (0.50 卤0.08) N and (0.22 卤0.07) N, respectively. When the flexion of the interphalangeal joint of the thumb was at 60 掳, the external forces were about (1.48 卤0.09) N and (1.15 卤0.04) N. Conclusion the abductor pollicis brevis muscle plays an important role in the dorsal extension of the interosseous joint of thumb and phalanx, so it is necessary to reconstruct the abductor pollicis brevis function simultaneously when transplanting the pectoralis minor muscle to reconstruct the function of thumb. It is possible to correct the flexion deformity of the interosseous joint of thumb and phalanx after the reconstruction of thumb-to-palm function.
【作者单位】：暨南大学第二临床医学院;深圳市人民医院手显微血管外科;
【基金】：广东省科技计划项目(2009B030801232)
【分类号】：R322

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