Biomechanical Study of Tendon Excursion of Thumb Muscles Related to Interphalangeal and Metacarpophalangeal Joint Motion

對人類大姆指肌腱移行及對應關節運動之動態學研究

羅祥麟(Cheung-Lun Law) ； Lawrence J. BerglundWilliam P. CooneyⅢ ； 安介南(Kai-Nan An)

《The Kaohsiung Journal of Medical Sciences》 5卷12期 (1989/12) Pp. 649-662

https://doi.org/10.6452/KJMS.198912.0649

摘要

我們運用小型旋轉電位計〈rotary poten-tiometer〉和電子量角器〈electrogoniometer〉完成了對人類大姆指內部及外部肌肉〈intrinsic and extrinsic muscles〉的肌腱滑動〈tendonexcursion〉和姆指指間關節〈interphalangeal joint〉及掌指關節〈metacarpo-phalangeal joint〉的對應運動作持續性觀察的生物力學研究。由觀察所得的數據可以得知各條肌肉在特定關節運動時的活動功能〈functional activities〉，同時亦可推算出肌腱和關節的旋轉中心〈center of rotation〉之間的力距〈moment arm〉。屈姆長肌〈extensor pollicis longus〉的肌腱滑動和姆指兩關節的對應屈曲幅度為穩定的線性關係。伸姆短肌〈extensor pollicis brevis〉和屈姆長肌對掌指關節外展和內展〈abduction and adduction〉的作用極小，而伸姆指長肌則具有使掌指關節內展的功用。姆外展短肌〈abductor pollicis brevis〉和姆內展肌橫頭〈adductor pollicis transverse head〉除了具有控制掌指關節內展及外展功能外，同時維持該關節的動態穩定，並透過背側腱膜〈dorsal aponeurosis〉來固定伸姆指長肌在掌指關節的背面。這些資料可以利用於大姆指功能重建手術如肌腱轉移〈tendon transfer〉，對向肌重建術〈opponensplasty〉，掌指關節副軔帶重建〈collateral ligament reconstruction〉等術前計劃和屈指肌腱斷裂縫合〈flexor tendon repair〉後的術後處理。

並列摘要

A biomechanical study of tendon excursion versus interphalangeal and metacarpophalangeal (MCP) joint motion relationships on extrinsic and intrinsic thumb muscles has been carried out. Continuous recording of excursion related to joint motion was obtained using a rotary potentiometer and an electrogoniometer. Functional activities of individual muscles were defined based on the excursion data. Moment arms of tendons were also derived. Flexor polices longus and extensor polices longus (EPL) tendons have a constant and linear relationship with flexion of the MCP joint. Extensor polices brevis and flexor polices longus contribute minimally in abduction-adduction. Extensor polices longus is a secondary adductor of the joint. Abductor polices brevis and adductor polices transverse head are important in dynamic stabilization of the MCP joint and to keep EPL tendon in proper position through the balance of dorsal aponeurosis. This information enables pre-operative planning for functional reconstruction of the thumb, such as in tendon transfers, opponensplasty, MCP joint collateral ligament reconstruction and post-operative management after flexor tendon repair.

並列關鍵字

excursion ； thumb muscles ； kinematics