Juncturae tendinum

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Juncturae tendinum
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Juncturae tendinum are seen between the tendons of the extensor digitorum communis.
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Identifiers
Latin Juncturae tendinum
TA98 A04.6.02.043
TA2 2501
Anatomical terms of muscle

In human anatomy, juncturae tendinum or connexus intertendinei refers to the connective tissues that link the tendons of the extensor digitorum communis, and sometimes, to the tendon of the extensor digiti minimi. [1] Juncturae tendinum are located on the dorsal aspect of the hand in the first, second and third inter-metacarpal spaces proximal to the metacarpophalangeal joint.

Contents

Structure

Juncturae tendinum are narrow bands of connective tissues that extend between the tendons of the extensor digitorum communis and the extensor digiti minimi. [1] [2] It is classified into three distinct types (Type 1, 2 and 3) depending on morphology. [3]

Histology

Histological structure of type 1 consists of tight tissue fibers and loose connective tissues. [4] The surrounding loose fibers are rich in blood vessels with pathways for nerves. [4] Tendinous fibers are rarely found and are in single direction. [4] Type 2 juncturae tendinum is also composed of single direction fibers like type 1, but with thicker bundles. [4] Histological structure of the type 3 juncturae is denser and thicker than type 2 juncturae and tendinous fibers are arranged in two layers. Tendinous fibers of the type 3 show crosswise direction with single direction and oblique bundles. [4] No muscular tissue is observed in any type of the juncturae tendinum.

Variations

Type 1 juncturae is mostly seen between the index and the middle fingers (second inter metacarpal space). [3] [4] [5] Type 2 juncturae is observed mainly between the middle and the ring fingers (third inter-metacarpal space). [2] [3] [4] [5] Type 3 juncturae tendinum is mostly found between the ring and the little finger (fourth inter-metacarpal space). [2] [3] [4] [5]

Normally, the extensor indicis proprius do not receive any juncture tendinum, [3] [6] but it is rarely seen and the mobility of the index finger is compromised. [2] The absence of the tendon of the extensor digitorum communis to the little finger is associated with the thicker type 3r juncturae tendinum in the fourth intermetacarpal space. [3]

Hirai et al. reported type 1 junturae tendinum between the extensor digiti minimi and the extensor digitorum communis to the ring finger in 6% of the specimens. [1]

Functions

Functionalities of juncturae tendinum include coordinating, force distributing, maintaining the space between the common extensor tendons during the extension of different fingers, and stabilizing the metacarpophalangeal joint. [2] [7] [8] Juncturae tendinum also acts as a compensatory slip for the little finger when the tendon of the extensor digitorum comunis to the little finger is absent. [9] However, the presence of juncturae tendinum may make it more difficult to extend each finger independently. [6] [10]

Additional image(s)

Related Research Articles

<span class="mw-page-title-main">Wrist</span> Part of the arm between the lower arm and the hand

In human anatomy, the wrist is variously defined as (1) the carpus or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand; (2) the wrist joint or radiocarpal joint, the joint between the radius and the carpus and; (3) the anatomical region surrounding the carpus including the distal parts of the bones of the forearm and the proximal parts of the metacarpus or five metacarpal bones and the series of joints between these bones, thus referred to as wrist joints. This region also includes the carpal tunnel, the anatomical snuff box, bracelet lines, the flexor retinaculum, and the extensor retinaculum.

<span class="mw-page-title-main">Extensor carpi radialis longus muscle</span> One of five forearm muscles controlling the wrist

The extensor carpi radialis longus is one of the five main muscles that control movements at the wrist. This muscle is quite long, starting on the lateral side of the humerus, and attaching to the base of the second metacarpal bone.

<span class="mw-page-title-main">Upper limb</span> Consists of the arm, forearm, and hand

The upper limbs or upper extremities are the forelimbs of an upright-postured tetrapod vertebrate, extending from the scapulae and clavicles down to and including the digits, including all the musculatures and ligaments involved with the shoulder, elbow, wrist and knuckle joints. In humans, each upper limb is divided into the arm, forearm and hand, and is primarily used for climbing, lifting and manipulating objects.

<span class="mw-page-title-main">Extensor digiti minimi muscle</span>

The extensor digiti minimi is a slender muscle of the forearm, placed on the ulnar side of the extensor digitorum communis, with which it is generally connected.

<span class="mw-page-title-main">Extensor digitorum muscle</span> Forearm muscle which extends the four fingers

The extensor digitorum muscle is a muscle of the posterior forearm present in humans and other animals. It extends the medial four digits of the hand. Extensor digitorum is innervated by the posterior interosseous nerve, which is a branch of the radial nerve.

<span class="mw-page-title-main">Opponens digiti minimi muscle of hand</span> Muscle in the hypothenar compartment

The opponens digiti minimi is a muscle in the hand. It is of a triangular form, and placed immediately beneath the palmaris brevis, abductor digiti minimi and flexor digiti minimi brevis. It is one of the three hypothenar muscles that control the little finger.

<span class="mw-page-title-main">Dorsal interossei of the hand</span> Muscles between the metacarpals

In human anatomy, the dorsal interossei (DI) are four muscles in the back of the hand that act to abduct (spread) the index, middle, and ring fingers away from the hand's midline and assist in flexion at the metacarpophalangeal joints and extension at the interphalangeal joints of the index, middle and ring fingers.

<span class="mw-page-title-main">Abductor digiti minimi muscle of hand</span> Muscle in the hypothenar compartment

In human anatomy, the abductor digiti minimi is a skeletal muscle situated on the ulnar border of the palm of the hand. It forms the ulnar border of the palm and its spindle-like shape defines the hypothenar eminence of the palm together with the skin, connective tissue, and fat surrounding it. Its main function is to pull the little finger away from the other fingers.

<span class="mw-page-title-main">Extensor indicis muscle</span> Forearm muscle which extends the index finger

In human anatomy, the extensor indicis (proprius) is a narrow, elongated skeletal muscle in the deep layer of the dorsal forearm, placed medial to, and parallel with, the extensor pollicis longus. Its tendon goes to the index finger, which it extends.

<span class="mw-page-title-main">Vincula tendina</span>

Within each osseo-aponeurotic canal, the tendons of the flexor digitorum superficialis and flexor digitorum profundus are connected to each other, and to the phalanges, by slender, tendinous bands, called vincula tendina.

<span class="mw-page-title-main">Deep transverse metacarpal ligament</span> Ligament that connects the palmar surfaces of the heads of the second to fifth metacarpal bones

The deep transverse metacarpal ligament connects the palmar surfaces of metacarpophalangeal joints of all the fingers of the hand except the thumb.

<span class="mw-page-title-main">Extensor retinaculum of the hand</span> A thickened fascia holding the tendons of the hand extensor muscles in place

The extensor retinaculum is a thickened portion of the antebrachial fascia that holds the tendons of the extensor muscles in place. It is located on the back of the forearm, just proximal to the hand. It is continuous with the palmar carpal ligament.

The posterior compartment of the forearm contains twelve muscles which primarily extend the wrist and digits. It is separated from the anterior compartment by the interosseous membrane between the radius and ulna.

<span class="mw-page-title-main">Palmar plate</span>

In the human hand, palmar or volar plates are found in the metacarpophalangeal (MCP) and interphalangeal (IP) joints, where they reinforce the joint capsules, enhance joint stability, and limit hyperextension. The plates of the MCP and IP joints are structurally and functionally similar, except that in the MCP joints they are interconnected by a deep transverse ligament. In the MCP joints, they also indirectly provide stability to the longitudinal palmar arches of the hand. The volar plate of the thumb MCP joint has a transverse longitudinal rectangular shape, shorter than those in the fingers.

Extensor digitorum brevis manus is an extra or accessory muscle on the backside (dorsum) of the hand. It was first described by Albinus in 1758. The muscles lies in the fourth extensor compartment of the wrist, and is relatively rare. It has a prevalence of 4% in the general population according to a meta-analysis. This muscle is commonly misdiagnosed as a ganglion cyst, synovial nodule or cyst.

<span class="mw-page-title-main">Extrinsic extensor muscles of the hand</span>

The extrinsic extensor muscles of the hand are located in the back of the forearm and have long tendons connecting them to bones in the hand, where they exert their action. Extrinsic denotes their location outside the hand. Extensor denotes their action which is to extend, or open flat, joints in the hand. They include the extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), extensor digitorum (ED), extensor digiti minimi (EDM), extensor carpi ulnaris (ECU), abductor pollicis longus (APL), extensor pollicis brevis (EPB), extensor pollicis longus (EPL), and extensor indicis (EI).

<span class="mw-page-title-main">Extensor medii proprius muscle</span>

The extensor medii proprius is a rare anatomical variant in the extensor compartment of the forearm. The aberrant muscle is analogous to the extensor indicis with the insertion being the middle finger instead of the index finger.

<span class="mw-page-title-main">Extensor indicis et medii communis muscle</span>

The extensor indicis et medii communis is a rare anatomical variant in the extensor compartment of forearm. This additional muscle lies in the deep extensor layer next to the extensor indicis proprius and the extensor pollicis longus. The characteristics of this anomalous muscle resemble those of the extensor indicis proprius, with split tendons to the index and the middle finger. This muscle can also be considered as a variation of the aberrant extensor medii proprius.

<span class="mw-page-title-main">Extensor pollicis et indicis communis muscle</span> Accessory muscle in the forearm

In human anatomy, the extensor pollicis et indicis communis is an accessory muscle in the posterior compartment of forearm. It was first described in 1863. The muscle has a prevalence from 0.5% to 4%.

Linburg–Comstock variation is an occasional tendinous connection between the flexor pollicis longus and the flexor digitorum profundus of the index, the middle finger or both. It is found in around 21% of the population. It is an anatomical variation in humans, which may be viewed as a pathology if causes symptoms. It was recognised as early as the 1800s, but was first described by Linburg and Comstock in 1979.

References

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  2. 1 2 3 4 5 6 7 8 9 Doyle, James R. (2003). Surgical Anatomy of the Hand and Upper Extremity. Lippincott Williams & Wilkins. ISBN   9780397517251.
  3. 1 2 3 4 5 6 7 von Schroeder, H. P.; Botte, M. J.; Gellman, H. (Jul 1990). "Anatomy of the juncturae tendinum of the hand". The Journal of Hand Surgery. 15 (4): 595–602. doi:10.1016/s0363-5023(09)90021-1. ISSN   0363-5023. PMID   2380523.
  4. 1 2 3 4 5 6 7 8 Pinar, Yelda; Bilge, Okan; Govsa, Figen; Celik, Servet; Aktug, Huseyin (2008). "Anatomo-histological analysis of the juncturae and their relations to the extensor tendons to the dorsum of the hand". Surgical and Radiologic Anatomy. 31 (2): 77–83. doi:10.1007/s00276-008-0402-x. ISSN   0930-1038. PMID   18726543. S2CID   10523222.
  5. 1 2 3 Dass, Prameela; Prabhu, Latha V.; Pai, Mangala M.; Nayak, Varsha; Kumar, Ganesh; Janardhanan, Jiji P. (2011). "A comprehensive study of the extensor tendons to the medial four digits of the hand". Chang Gung Medical Journal. 34 (6): 612–619. ISSN   2309-835X. PMID   22196064.
  6. 1 2 Tang, Jin Bo; Amadio, Peter C.; Guimberteau, Jean Claude; Chang, James (2012-04-23). Tendon Surgery of the Hand. Elsevier Health Sciences. ISBN   978-1455737420.
  7. von Schroeder, H. P.; Botte, M. J. (Feb 2001). "Anatomy and functional significance of the long extensors to the fingers and thumb". Clinical Orthopaedics and Related Research. 383 (383): 74–83. doi:10.1097/00003086-200102000-00010. ISSN   0009-921X. PMID   11210972.
  8. Agee JM, Guidera M (1980) The functional significance of juncturae tendinea in dynamic stabilization of the metacarpophalangeal joints of the Wngers. J Hand Surg 5A:288–289
  9. Schenck, R. R. (Jan 1964). "Variations of the Extensor Tendons of the Fingers. Surgical Significance". The Journal of Bone and Joint Surgery. American Volume. 46: 103–110. doi:10.2106/00004623-196446010-00010. ISSN   0021-9355. PMID   14104299.
  10. Benjamin, M; Kaiser, E; Milz, S (2008). "Structure-function relationships in tendons: a review". Journal of Anatomy. 212 (3): 211–228. doi:10.1111/j.1469-7580.2008.00864.x. ISSN   0021-8782. PMC   2408985 . PMID   18304204.