【摘要】 目的 :观察小指伸指肌腱的形态解剖学和功能解剖学特点 ,为小指固有伸肌腱移位后小指伸指障碍的防治方法提供解剖学依据。方法 :观察 2 0 6只手的小指固有伸肌腱、小指指总伸肌腱和第四掌骨背侧指总伸肌腱尺侧束的解剖学特征 ,测量伸向小指的指总伸肌腱的倾斜角 ,并分类记录拍照。结果 :①按形态学将伸向小指的指总伸肌腱分为四大类型 :独立型 8.3% (17/ 2 0 6 )、分叉型及其“r”亚型 5 1.0 % (10 5 / 2 0 6 )与“y”亚型 2 9.6 % (6 1/ 2 0 6 )、分离障碍型 4 .4 % (9/ 2 0 6 )和缺如型 6 .8% (14 / 2 0 6 )。②按生物力学特点也分为四大类型 :力线标准型 4 6 .1% (95 / 2 0 6 )、力线偏离度小型 4 0 .8% (84 / 2 0 6 )、力线偏离度大型 6 .3% (13/ 2 0 6 )和缺如型 6 .8% (14 / 2 0 6 )。③除缺如型外 ,第四掌骨背侧指总伸肌腱尺侧束的尺侧头均以腱束止于小指伸肌腱 [93.2 % (192 / 2 0 6 ) ]。结论 :①第四掌骨背侧指总伸肌腱尺侧束的桡侧头是腱结合 ,其尺侧头是伸向小指的指总伸肌腱的延续 ,与EDCs是同一解剖结构 ,其出现率为 88.8%。②分叉型、分离障碍型和缺如型是小指指总伸肌腱解剖变异的不同形式。③腱结合切断术、腱短缩术和腱重建术是防治小指固有伸肌腱移位术后小指伸指障碍的有效方法更多还原

【Abstract】 Objective:To study the morphological and functional anatomy of small finger extonsors to prevent or treat handicapped extension of small finger after extensor digiti quinti(EDQ) transfer.Methods:206 adult hands were dissected,photographed and observed.Morphology of EDQ,extensor digiti communis(EDC) to small finger or uluar slip of extensor over the fourth metacarpus (EOFM) were observed and classified, and then the deviation angle of tendinous structure extending to small finger were measured.Results:①EDC to small finger (EDCs) can be classified morphologically into 4 types:independent type [8.3%(17/206)],branch-off type with “r” subtype [51.0%(105/206)] and “y” subtype [29.6%(61/206)],inseparable type [4.4%(9/206)] and absent type [6.8(14/206)]. ②EDCs can be classified biomechanically into 4 types:standard type [46.1%(95/206)],lesser deviation type [40.8%(84/206)],greater deviation type [6.3%(13/206)] and absent type [6.8%(14/206)].③Most of the ulnar slip of EOFM except absent type is tendinous structure [93.2%(192/206)].Conclusion:①The radial slip of EOFM is tendinous juncutae tendinum,and its ulnar slip is the terminal structure of EDCs.EDCs and ulnar slip of EOFM is the same structure,and present in 88.8% hands.②Branch-off type,inseparable type and absent type are the variation types of EDCs.③Section of junctura tendinum,shortening of EDCs or reconstruction of EDCs are effective methods to prevent or treat handicapped small finger extension after EDQ transfer.更多还原