掌腱膜滑车形态结构及功能解剖学研究

目的　通过解剖学研究了解掌腱膜滑车 (palmaraponeurosis,PA)、A1 滑车和指屈肌腱的生物力学关系。方法　解剖 1 8只新鲜尸体手标本并从腕部桡、尺动脉灌注中华墨汁 ,观察并测量掌腱膜滑车与A1 滑车的宽度及形态学、组织学的变化。结果　掌腱膜滑车平均宽 1 0～ 1 2mm ,A1 滑车平均宽 5.5～7.0mm ,两者差异有显著性意义 (t=1 2 .0 2 ,P <0 .0 1 )。掌腱膜滑车的结构疏松 ,与指屈肌腱之间的间隙大 ,滑车作用不明显。PA滑车富含血管 ,与指屈肌腱滑液囊近端有血管联系。结论　PA滑车的作用小 ,PA滑车血管与鞘内肌腱血管有联系 ,是鞘内近端肌腱的营养途径之一。

Palmar aponeurosis pulley: morphologic and anatomical study

Objective To investigate the biomechanics relationship of the pulley of palmar aponeurosis(PA) , A1 and finger flexors through anatomical study. Methods 18 fresh cadaveric hands were involved in the study. The Chinese ink was filled into the radial and ulnar arteries at the wrist. The pulley width of PA and A1 were measured and their morphological and histological changes were observed. Results The average width of PA and A1 pulley were 10 12mm and 5.5 7.0mm respectively. There were statistically significant difference between them. The structure of PA pulley was more loose than that of A1. There was a larger gap between PA pulley and flexors tendon of fingers, resulting in no marked pulley function. There was abundant vessels at PA pulleys, which was connected with the proximal part of synovial bursa of finger flexor tendons.Conclusions PA is not an important pulley. The blood supply of PA pulley is connected with tendon vessels inside sheath, which functions as one of nutrition for the proximal tendons inside the sheath.