论文部分内容阅读
采用30’只成人尸体固定手，选其示、中、环、小指共计120指，用6倍手术显微镜观察了各滑车的出现情况、形态特点、附着部位、及体表投影，并测量了各滑车最掌侧面的宽度。发现滑车系统由5个环形滑车（AI、AZ‘A3、A4、AS）、4个交叉滑车（CO、CI、CZ、C3）和1个掌位膜滑车（PA滑车）构成。PA滑车由掌位膜横行纤维构成，位于掌骨头近侧。AI、A3、AS滑车分别位于MP关节、PIP关节、DIP关节部位，主要附着于相应的关节掌权，AZ、A4滑车分别位于近节指骨和中节指骨，AZ附着于近节指骨近侧3／5，A4滑车附着于中节指骨近侧半的远侧半。交叉滑车位于环形滑车之间，一般一端附着于掌板，一端附着手指骨。环形滑车在各指均恒定出现，形态变异小，而交叉滑车除CI、C3较恒定出现外，CO、CZ出现率较低（分别为35％、525％）。交叉滑车的形态变异较大，除交叉形态外，还有单一斜形、环形、“Y”形及不规则形。环形滑车中AZ最宽，平均为16.8mm，其次是A1（7.1mm）和A4（6．3mm），A3和AS较为薄弱。AZ滑车远端和A4滑车中部是腱鞘最厚的部位，与肌腱相贴紧密。滑车的形态特点及分布与其功能密切相关。交叉滑车出现不恒定且变异较大，说明其防止肌腱形成弓弦的作用是次要的，但它们增加了肌腱的强度；而环形滑车恒定出现?
30 adult adult cadaver hands were used to select the middle, the ring and the little finger for a total of 120 fingers. The occurences, morphological characteristics, attachment sites, and body surface projections of each trolley were observed with a 6-fold surgical microscope. The width of the most palm side of the pulley. The tackle system was found to consist of five ring blocks (AI, AZ’A3, A4, AS), four cross blocks (CO, CI, CZ, C3) and one palm film block (PA block). PA pulley from the palmar membrane transverse fibers, located in the proximal metacarpal. The AI, A3 and AS trolleys are located at MP joint, PIP joint and DIP joint, respectively. They are mainly attached to the corresponding joints. AZ and A4 trolley are located in the proximal phalanx and middle phalange respectively. AZ is attached to the proximal phalanx 3 / 5, A4 pulley attached to the distal half of the phalanges in the middle half. Crossover trolley located between the pulley, usually attached to the palm plate at one end, attached to one end of the finger bone. The ring block showed a constant appearance at each finger, with small variation in shape. However, the occurrences of CO and CZ were lower (35% and 525%, respectively) except for the CI and C3 overcrowding. Crossover pulley shape variation, in addition to the cross shape, there are a single oblique, circular, “Y” shape and irregular shape. The widest AZ in the block, averaging 16.8mm, followed by A1 (7.1mm) and A4 (6.3mm), with weaker A3 and AS. The distal part of the AZ pulley and the middle part of the A4 pulley are the thickest parts of the tendon sheath, which are in close contact with the tendon. The characteristics and distribution of the trolley are closely related to its function. Crossovers are not constant and vary significantly, indicating that their role in preventing the formation of bowstring tendons is secondary, but they increase the strength of the tendons; and the constant appearance of the cycloid?