王洛夫 张正治 刘正津 400038 重庆， 第三军医大学解剖教研室 中华手外科杂志 1999 0 15 2


    关键词：指；腱；解剖学；局部 期刊 zhswkzz 0 肌腱 fur -->


    

【摘要】 目的 为滑车重建提供形态学依据。 方法 于手术显微镜下对30只尸手标本，进行滑车系统的形态学观察，测量手指伸直位时各滑车之间的间距，手指在屈曲过程中各滑车间距的变化。 结果 A₂ 滑车最宽，达16.8 mm，A₂ 远端部和A₄ 中间部是腱鞘最厚的部位，约1 mm 厚。 滑车间距：中间部位的滑车(C₁ ～ A₃ ～ C₂ )间距较大，两端部位的滑车(A₁ ～ C₀ ～ A₂ ～ C₁ 、C₂ ～ A₄ ～ C₃ )间距较小；A₂ 远端缘和A₄ 近端缘分别位于近节指骨近端3 / 5 ～ 2 / 3和中节指骨近端1 / 4以远，其间距平均为20.8 mm。 结论 A₂ 的远端部分和A₄ 近端部分滑车的作用最为重要，滑车应重建在该两部位。

Clinical anatomy of the human finger pulleys

WANG Luofu, ZHANG Zhengzhi, LIU Zhengjin. Department of Anatomy, Third Military Medical University, Chongqing 400038

【Abstract】 Objective To provide morphologic basis for finger pulley reconstruction. Methods 30 adult cadaveric hands were dissected under the operating microscope. Morphologic observation and measurement of the pulley apparatus were carried out, with emphases on measuring the distance between the pulleys when the digits were extended,and observing the changes of pulley intervals during finger flexion. Results The A₂ pulley was the widest (16.8 mm). The distal portion of the A₂ pulley and the central portion of the A₄ pulley were the thickest part of the flerxor tendon sheath(about 1 mm). The distance between the pulleys (C₁ ～ A₃ ～ C₂ ) around the proximal interphalangeal joint was large, whereas the distance between the pulleys (A₁ ～ C₀ ～ A₂ ～ C₁ , C₂ ～ A₄ ～ C₃ ) located on the proximal and middle phalanxes was small. The distal edge of the A₂ pulley was level with the proximal 3 / 5 ～ 2 / 3 of the proximal phalanx, while the proximal edge of the A₄ pulley was located at the distal end of the proximal 1 / 4 of the middle phalanx, the distance in between being 20.8 mm on average. Conclusions The distal portion of the A₂ pulley and the proximal portion of the A₄ pulley are the most important structures of the pulley apparatus, which should be repaired when performing pulley reconstruction.

     ......