Investigations concerning the structure and topography formation of the palmar aponeurosis and its morphometric characteristics in all stages during fetal and early periods of ontogenesis of the human being determines morphological basis and is important for the establishment of the developmental criteria of the palmar aponeurosis and compliance with the terms of gestation. Objective: to elucidate peculiarities of the structure and topography of the palmar aponeurosis and to determine its morphometric parameters in fetuses and neonates. Material and methods. Investigations of the ontogenetic transformations of the palmar aponeurosis were conducted on 51 specimens of the dead fetuses (from 4 to 10 months) 165,0mm – 500,0mm of the parietal-calcaneal length (PCL) and 10 neonates by means of the adequate anatomical methods: macro-dissection, preparation of topographicanatomical sections, radiography, morphometry. Statistical analysis of the data obtained was processed by means of the licensed software RStudio. Results. At the end of the fetal period of ontogenesis the palmar aponeurosis is found to become of a definite structure and during the perinatal period its organometric parameters increase and two periods of accelerated development and the period of relatively slow development are peculiar for it. Conclusions. 1. During the third trimester of the intrauterine development and neonatal period the palmar aponeurosis is of a triangular shape, dense, occupies the middle palmar space, possesses clear borders and is located between the muscles of the little finger and thumb elevation, its shape resembles a definite structure. 2. Two periods of accelerated development and the period of a relatively slow morphogenesis of the right and left palmar aponeurosis are established in human fetuses and newborns. The periods of accelerated development for the length and width of the right and left palmar aponeurosis are from the 4th to the 5th month and from the 7th month of the intrauterine development to the neonatal period. The period of a slow development for the length and width is from the 5th to the 7th months of the intrauterine development. 3. The values of all the paired coefficients of correlation between all organometric parameters of the palmar aponeurosis during the fetal and early perinatal period are positive and close to 1, which is indicative of a close positive correlation. A significant difference of the mean medians for all possible age pairs is statistically important, except those pairs for the length of the right aponeurosis: «5 month – 6 month», «5 month – 7 month», «6 month – 7 month», «7 month – 8 month», «8 month – 9 month», «9 month – 10 month», for the length of the left one – «5 month – 6 month», «6 month – 7 month», «8 month – 9 month», «9 month – 10 month», for the width of the right aponeurosis – «5 month – 6 month», «5 month – 7 month», «8 month – 9 month», for the width of the left one – «5 month – 7 month», «5 month – 8 month», «8 month – 9 month», «10 month – neonates». 4. The patterns of the prognosticate standard values of the palmar aponeurosis organometric parameters during the fetal and early perinatal periods of ontogenesis are the following: for the length – the length of the palmar aponeurosis = β0 + 0,022 х parietal-calcaneal length of the fetus, where β0 : 3,531, in case the term of gestation is 4 months; 6,532 = 5 months; 6,851 = 6 months; 6,526 = 7 months; 7,583 = 8 months; 7,044 = 9 months; 6,964 = 10 months; 7,968 = neonates; for the width – the width of the palmar aponeurosis = β0 + 0,018 х parietal-calcaneal length of the fetus, where β0 : 2,624, in case the term of gestation is 4 months; 5,431 = 5 months; 3,701 = 6 months; 4,233 = 7 months; 4,121 = 8 months; 3,602 = 9 months; 3,956 = 10 months; 4,881 = neonates.
Read full abstract