指背腱膜的功能解剖及临床意义

目的：进一步探讨指背腱膜的构成特点及临床意义。方法：在30只成人手标本上，通过模拟手术，对指背腱膜的构成特点进行了应用解剖学观测。结果：指背腱膜的构成复杂，其中的外侧腱束、外侧束、外侧腱和中央束在手指畸形的发生中有着特殊的临床意义。外侧腱束主要形成伸近节指间关节的功能解剖机制；其与外侧束形成的密切纤维联系而具有协同外侧腱的功能；该腱束与屈肌腱鞘有联系又使其具有平衡屈肌和伸肌肌力的作用。中央束在指背腱膜的整体协调、畸形的发生及矫正过程中起着重要的功能。结论：通过对指背腱膜的解剖研究，可用以解释因指屈、伸肌腱平衡被破坏后所形成的畸形，并可进一步探讨畸形的发生机理和解决这些畸形的新术式。

Functional anatomy and clinical significance of the extensor apparatus

Objective: To explore deeply functional construction and clinical significance of the extensor apparatus.Methods:Through simulated operation,the functional structures of the extensor apparatus were observed in 30 adult hand specimens using operating microscope.Results:The formation of the extensor apparatus was very complicated,of which the lateral tendinous fascicle,lateral fascicle,lateral tendon and intermediate fascicle had special clinical significance in the occurring of hand deformation.The lateral tendinous fascicle formed mainly functional anatomic mechanism of the proximal interphalangeal joint was extended,and it had close relation to the lateral fascicle and had a coordinated action with the lateral tendon.The lateral tendinous fascicle had also association with the flexor tendinous sheath,and made the flexor tendinous sheath play a role in balancing muscular strength of flexor and extensor.The intermediate fascicle played an important function in phlangeal function coordination,malformation occurring and correction.Conclusions:Through the anatomic studies of the extensor gales aponeurotica we can know that the occurring of deformations is because the balance of the flexor and extensor tendons lost.On the basis of the anatomical data the malformation mechanism can be explored and new operating methods can be developed.