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目的解剖拇指腕掌关节周围各条韧带及观察其组织形态学特征,探讨其在拇指腕掌关节稳定性中的作用。方法采用大体解剖学方法对10例新鲜冰冻手标本进行解剖,识别拇指腕掌关节周围韧带的连接部位与方向性,对韧带的宽度、长度、厚度进行形态学对比分析。并组织学观察拇指腕掌关节背侧和掌侧韧带细胞数。结果确定拇指腕掌关节周围存在7条主要韧带:即由3条背侧韧带(桡背侧韧带、背侧中央韧带、后斜韧带)组成的复合体,厚度分别为(1.24±0.12)、(1.91±0.15)、(1.61±0.12)mm。2条掌侧韧带(前斜韧带、尺侧副韧带),厚度分别为(0.78±0.11)mm、(1.03±0.11)mm。2条尺侧韧带(大多角骨-第1掌骨背侧韧带,第1、2掌骨间韧带),厚度分别为(0.78±0.19)mm、(0.89±0.19)mm。背侧韧带明显厚于掌侧韧带(P<0.01),桡背侧韧带、背侧中央韧带、后斜韧带的细胞数多于前斜韧带,后斜韧带的细胞数也多于尺侧副韧带,均有统计学差异(P<0.05)。结论 3条背侧韧带组成粗厚坚韧的复合体,在拇指腕掌关节的稳定中,前斜韧带起着更大的作用。
Objective To dissect the ligaments around the wrist of the thumb and to observe its histomorphological characteristics and to explore its role in the stability of the thumb wrist joint. Methods Ten fresh frozen hands specimens were dissected by gross anatomy. The ligaments and directionality of the ligaments around the thumb and wrist joints were identified. The width, length and thickness of the ligaments were morphologically analyzed. Histological observation was performed to observe the number of dorsal and palmar ligament cells in the wrist. The results showed that there were 7 main ligaments around the wrist of the thumb: the complex consisted of 3 dorsal ligaments (dorsal medial dorsal ligament and posterior oblique ligament) with thicknesses of (1.24 ± 0.12) and ( 1.91 ± 0.15), (1.61 ± 0.12) mm. The thickness of the two palmar ligaments (anterior oblique ligament and ulnar collateral ligament) were (0.78 ± 0.11) mm and (1.03 ± 0.11) mm, respectively. The thickness of the two ulnar ligaments (MPR - the first metacarpal ligament and the first and second metacarpal ligaments) were (0.78 ± 0.19) mm and (0.89 ± 0.19) mm respectively. The dorsal ligaments were significantly thicker than the metacarpal ligaments (P <0.01). The number of cells in the dorsal radial, dorsal medial ligaments and posterior oblique ligaments was greater than that in anterior oblique ligaments. The posterior oblique ligaments also had more cells than ulnar collateral ligaments , All with statistical difference (P <0.05). Conclusions The three dorsal ligaments form a thick and tough complex, and the anterior oblique ligament plays a greater role in the stability of the thumb and wrist joint.