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Digital flexor tendon sheath: an anatomic study.

B Strauch, W de Moura

    The Journal of Hand Surgery
    |November 1, 1985
    PubMed
    Summary
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    This study reveals the human flexor sheath as a specialized bursal environment crucial for finger flexion and extension. It details an organized pulley system and vascular anatomy within the flexor sheath.

    Area of Science:

    • Anatomy
    • Biomechanics
    • Histology

    Background:

    • The flexor sheath's complex anatomy has historically presented challenges in understanding its function.
    • Previous descriptions lacked clarity regarding its role in digital motion and its internal structures.

    Purpose of the Study:

    • To elucidate the detailed anatomy of the human flexor sheath.
    • To describe the vascular system and pulley mechanisms within the flexor sheath.
    • To provide a clearer understanding of the flexor sheath's role in finger flexion and extension.

    Main Methods:

    • Microscopic examination of 72 human cadaver digits using fiberoptic and polarizing light.
    • Dissection at magnifications of 8x to 25x.
    • Histological analysis of longitudinal and cross-sections after latex injection of the vascular system.

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    Main Results:

    • The flexor sheath functions as a contained bursal environment.
    • An orderly, repeating system of proximal and distal pulleys was identified.
    • Detailed descriptions of vascular anatomy, proximal cul-de-sac, and vincular system relationships were established.

    Conclusions:

    • The flexor sheath possesses specialized anatomy facilitating flexion and extension.
    • The pulley system is an organized, repeating structure.
    • Understanding the vascular and anatomical relationships is key to comprehending flexor sheath function.