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目的研究前臂骨骼肌亚部的形态学特征及肌构筑特点,探讨肌亚部化移植的可行性,为临床肌亚部移植手术提供形态学依据。方法第二军医大学解剖学教研室提供的冰冻上肢标本10例20侧,均为男性,年龄26～39岁。用改良Sihler染色法对10侧桡侧腕屈肌、尺侧腕屈肌、桡侧腕短伸肌、尺侧腕伸肌、掌长肌、拇长屈肌及旋前圆肌进行肌内神经染色,以观察肌内神经的分支分布。另取10侧标本,前臂上述肌肉沿肌腱长轴分为尺侧半和桡侧半,根据Wickiewicz肌构筑研究方法测量其构筑学特征。结果各肌肉神经在入肌前或入肌后发出2支或以上神经分支,分别进入尺侧半和桡侧半。各分支以肌内腱板为界,两侧的肌内神经各支配一侧肌肉。各肌肉所分成的两亚部之间,生理横切面积相比差异均有统计学意义(P<0.05);其中以尺侧腕屈肌尺侧半最大,掌长肌两亚部及旋前圆肌尺侧半较小。各肌肉两亚部之间生理横切面积与肌湿重比值,差异均无统计学意义(P>0.05)。生理横切面积与肌纤维长度比值,旋前圆肌尺侧半、掌长肌两亚部较高,尺侧腕屈肌尺侧半最小,与其余各亚部比较差异有统计学意义(P<0.05);其余各亚部间差异无统计学意义(P>0.05)。结论前臂各肌可分为尺侧半和桡侧半两亚部;各亚部的生理功能特征存在差异;对选择和切取理想的部分肌肉移植,重建运动功能提供了理论依据。
OBJECTIVE: To study the morphological characteristics and muscular architecture characteristics of the forearm skeletal muscle subtypes, and to explore the feasibility of submyotrophic grafting to provide a morphological basis for clinical muscularis subplant transplantation. Methods Frozen upper limb specimens from 20 anatomical departments of the Second Military Medical University were enrolled in the study. All 20 men were male, aged 26-39 years old. The modified Sihler staining was used to evaluate the effects of intramuscular nerves on the 10 carpus flexors, the flexor carpi ulnaris, the extensor carpi ulnaris, the extensor carpi ulnaris, the palmar longus, the flexor hallucis and the anterior pronator Staining to observe the branching distribution of intramuscular nerves. Another 10 specimens were taken. The muscles of the forearm were divided into the ulnar half and the radial side along the long axis of the tendon, and their architectural features were measured according to Wickiewicz’s method of muscle construction. Results Each muscle nerve before or after entering the muscle issued two or more nerve branches, respectively, into the ulnar half and radial side half. Each branch to the intramuscular tendon bounded, both sides of the intramuscular nerve dominate the side of the muscle. There was a significant difference in physiological cross-sectional area between the two sub-regions divided by each muscle (P <0.05). Among them, the maximal ulnar flexor carpi ulnar half maxilla, Lateral ulnar half smaller. There was no significant difference in the ratio of physiological cross-sectional area and muscle wet weight between the two sub-muscles of each muscle (P> 0.05). The ratio of physiological cross-sectional area to muscle fiber length was significantly higher in the ulnar and semicircular semiconnecula than in the other subdivisions (P < 0.05). There was no significant difference among the other sub-groups (P> 0.05). Conclusion The forearm muscles can be divided into two parts: the ulnar hemisphere and the radial hemisphere. The physiological function of each subunit is different. It provides a theoretical basis for the selection and removal of the ideal part of muscle transplantation and reconstruction of motor function.