Advertisement

Surgical and Radiologic Anatomy

, Volume 31, Issue 2, pp 77–83 | Cite as

Anatomo-histological analysis of the juncturae and their relations to the extensor tendons to the dorsum of the hand

  • Yelda Pinar
  • Okan Bilge
  • Figen Govsa
  • Servet Celik
  • Huseyin Aktug
Original Article

Abstract

The juncturae tendinum (JT) may coordinate the extension of hand, force redistribution and the stabilization of the metacarpophalangeal joint. The JT were studied for their gross appearance, shape, thickness, location and histological examination with the dorsum of the hand in 54 cadavers. The JT were identified into three groups according to their anatomo-histological features. The type 1 was observed in 57.4% of the cases in the second IMC and in 16.7% of the cases in the third IMC. The type 2 was detected in 3.7% of the cases in the second IMC and in 59.3% of the cases in the third IMC space. The type of 3Y was accounted for 14.8% JT in the third IMC space and 53.7% JT in the fourth space. The type of 3r was found in 5.55% of the cases in the third IMC and in 37% of the cases in the fourth IMC space. In the histologic examination, the fibers of types 1 and 2 JTs were straight. Type 3 JTs were composed of regularly oriented parallel and crosswise bundles of tendineous tissue. This study is important in terms of giving accurate knowledge on the anatomo-histological analysis of the JTs and their relations to the extensor tendons to the dorsum of the hand. An understanding of the structures of the JTs and the interactions between the tendons of the fingers is of utmost importance in hand assessment, during the reconstructive procedures such as considering the tendons to be transferred.

Keywords

Extensor digitorum Juncturae Extensor tendon Reconstruction Hand surgery 

References

  1. 1.
    Agee JM, Guidera M (1980) The functional significance of juncturae tendinea in dynamic stabilization of the metacarpophalangeal joints of the fingers. J Hand Surg 5A:288–289Google Scholar
  2. 2.
    Benatar N (1994) Radial subluxation of the connexus intertendineus at the MP joint of the little finger in musicians treated by connexus intertendineus proximalization. J Hand Surg 18B:81–87Google Scholar
  3. 3.
    Bonatz E, Kramer TD, Masear VR (1996) Rupture of the extensor pollicis longus tendon. Am J Orthop 25(2):118–122PubMedGoogle Scholar
  4. 4.
    Browne EZ Jr, Teague MA, Snyder CC (1979) Prevention of extensor lag after indicis proprius tendon transfer. J Hand Surg Am 4(2):168–172PubMedGoogle Scholar
  5. 5.
    Culver JE (1980) Extensor pollicis and indicis communis tendon: a rare anatomic variation revisited. J Hand Surg 5A:548–549Google Scholar
  6. 6.
    El-Badawi MGY, Butt MM, Al-Zuhair AGH, Fadel RA (1995) Extensor tendons of the fingers: arrangement and variations-II. Clin Anat 8:391–398PubMedGoogle Scholar
  7. 7.
    Gelb RI (1995) Tendon transfer for rupture of the extensor pollicis longus. Hand Clin 11(3):411–422PubMedGoogle Scholar
  8. 8.
    Gonzalez MH, Gray T, Ortinau E, Weinzweig N (1995) The extensor tendons to the little finger: an anatomic study. J Hand Surg 20A:844–847Google Scholar
  9. 9.
    Hirai Y, Yoshida K, Yamanaka K, Inoue A, Yamaki K, Yoshizuka M (2001) An anatomic study of the extensor tendons of the human hand. J Hand Surg Am 26(6):1009–1015PubMedGoogle Scholar
  10. 10.
    Kameyama M, Shiraishi T (2000) Traumatic rupture of the extensor digitorum communis and extensor digiti minimi at the musculotendinous junction associated with volar dislocation of the distal radioulnar joint–a case report. Hand Surg 5(2):165–168PubMedGoogle Scholar
  11. 11.
    Kaneff A (1963) Verleichend-Morphologische Untersuchungen über die Zwischensehnenverbindungen (connexus intertendinei) des M. extensor Digitorum beim Menschen. Morphologiae 104:147–176Google Scholar
  12. 12.
    Kaplan EB (1959) Anatomy, injuries and treatment of the extensor apparatus of the hand and fingers. Clin Orthop 13:24–41Google Scholar
  13. 13.
    Kitano K, Tada K, Shibata T, Yoshida T (1996) Independent index extension after indicis proprius transfer: excision of juncturae tendinum. J Hand Surg Am 21(6):992–996PubMedGoogle Scholar
  14. 14.
    Komiyama M, Nwe TM, Toyota N, Shimada Y (1999) Variations of the extensor indicis muscle and tendon. J Hand Surg Br 24(5):575–578PubMedGoogle Scholar
  15. 15.
    Leslie DR (1954) The tendons of the dorsum of the hand. Aust N Z J Surg 23:253–256PubMedGoogle Scholar
  16. 16.
    Littler JW (1967) The finger extensor mechanism. Surg Clin North Am 47(2):415–432PubMedGoogle Scholar
  17. 17.
    Moore JR, Weiland AJ, Valdata L (1980) Independent index extension after extensor indicis proprius transfer. J Hand Surg 5:288–289Google Scholar
  18. 18.
    Nishida J, Amadio PC, Bettinger PC, An KN (1999) Flexor tendon-tendon sheath interaction after tendon grafting: a biomechanical study in a human model in vitro. J Hand Surg Am 24(5):1097–1102PubMedGoogle Scholar
  19. 19.
    Ogura T, Inoue H, Tanabe G (1987) Anatomic and clinical studies of the extensor digitorum brevis manus. J Hand Surg Am 12(1):100–107PubMedGoogle Scholar
  20. 20.
    Rockwell WB, Butler PN, Byrne B (2000) Extensor tendon: anatomy, injury, and reconstruction. Plast Reconstr Surg 106:1592–1603PubMedGoogle Scholar
  21. 21.
    Schenck R (1964) Variations of the extensor tendons of the fingers. Surgical significance. J Bone Joint Surg Am 46:103–110PubMedGoogle Scholar
  22. 22.
    von Schroeder HP, Botte MJ, Gellman H (1990) Anatomy of the juncturae tendinum of the hand. J Hand Surg 15A:595–602Google Scholar
  23. 23.
    von Schroeder HP, Botte MJ (1993) The functional significance of the long extensors and juncturae tendinum in finger extension. J Hand Surg Am 18(4):641–647Google Scholar
  24. 24.
    von Schroeder HP, Botte MJ (1995) Anatomy of the extensor tendons of the fingers: variations and multiplicity. J Hand Surg Am 20(1):27–34Google Scholar
  25. 25.
    Seradge H, Tian W, Roberts C (1999) Clinical significance of an extensor tendon anomaly to the little finger-a new finding. J Okla State Med Assoc 92(1):7–9PubMedGoogle Scholar
  26. 26.
    Seradge H, Tian W, Baer C (1999) Anatomic variation of the extensor tendons to the ring and little fingers: a cadaver dissection study. Am J Orthop 28(7):399–401PubMedGoogle Scholar
  27. 27.
    Siegel D, Gebhardt M, Jupiter JB (1987) Spontaneous rupture of the extensor pollicis longus tendon. J Hand Surg Am 12(6):1106–1109PubMedGoogle Scholar
  28. 28.
    Shah MA, Buford WL, Viegas SF (2003) Effects of extensor pollicis longus transposition and extensor indicis proprius transfer to extensor pollicis longus on thumb mechanics. J Hand Surg Am 28(4):661–668PubMedGoogle Scholar
  29. 29.
    Tan ST, Smith PJ (1999) Anomalous extensor muscles of the hand: a review. J Hand Surg Am 24(3):449–455PubMedGoogle Scholar
  30. 30.
    Wehbe MA (1992) Junctura anatomy. J Hand Surg 17:1124–1129CrossRefGoogle Scholar
  31. 31.
    Zilber S, Oberlin C (2004) Anatomical variations of the extensor tendons to the finger over the dorsum of the hand: a study of 50 hands and a review of the literature. Plast Reconstr Surg 113:214–221PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Yelda Pinar
    • 1
  • Okan Bilge
    • 1
  • Figen Govsa
    • 1
  • Servet Celik
    • 1
  • Huseyin Aktug
    • 2
  1. 1.Department of Anatomy, Faculty of MedicineEge UniversityIzmirTurkey
  2. 2.Department of Embryology and Histology, Faculty of MedicineEge UniversityIzmirTurkey

Personalised recommendations