足底腱膜的解剖

目的观察足底腱膜的形态结构,为临床应用提供相关的解剖学资料。方法解剖50只10%甲醛固定的足,观察足底腱膜浅层的形态结构;测量足底腱膜中间部(跖腱膜)止于跖骨头处内、外侧纤维束的厚度与长度;跖腱膜中间部的厚度。结果足底腱膜浅层的纤维结构主要参与前外侧部足底脂肪垫的构成,并形成与足底皮纹相似的螺旋纤维板状结构,足跟部足底腱膜浅层的纤维结构较为稀疏。中间部的厚度为(2.168±0.1139)mm;跖腱膜于第1跖骨头处内、外侧纤维束的厚度分别为(1.33±0.08)mm、(1.46±0.07)mm,明显大于止于2~5跖骨头处的内、外侧纤维厚度,P0.05;第5跖骨头处的内、外侧纤维厚度分别为(0.29±0.02)mm、(0.37±0.04)mm,明显小于1~4跖骨头处的内、外侧纤维厚度,P0.05。结论足底腱膜浅层主要参与足前外侧脂肪垫的构成,足底腱膜深层对维持足部纵弓的稳定起着非常重要的作用,在足部受力时有效地避免足前部趾足底总神经、趾足底总血管受压。

Anatomy of the plantar fascia

Objective To observe the plantar aponeurosis and to provide relevant anatomic data for clinical application.Methods Fifty formalin fixed feet were dissected and the superficial layer of the plantar fascia was observed.The thickness and length of the medial and lateral fibrous bundles at the middle part of the plantar aponeurosis that ends at the head of the metatarsal bones (plantar fascia) were measured.The thickness of the middle part of the plantar fascia was examined.Results The fibrous structure of the superficial layer of the plantar aponeurosis mainly participated in the formation of the anterolateral plantar fat pad,and formed a spiral fibrous-lamina structure similar to the plantar cleavage lines.The fibrous structure of the superficial layer of the plantar aponeurosis at the heel was relatively sparse.The thickness of the middle part was (2.168 ± 0.1139) mm.The thickness of the fibre bundle of the plantar fascia at the medial and lateral side of the first toe bones was (1.33 ± 0.08) mm,and (1.46 ± 0.07) mm,which was significantly larger than that at the 2-5 toe,P ＜0.05.The thickness of the fibres at the medial and lateral side of the fifth toe bones was (0.29 ± 0.02) mm,(0.37 ± 0.04) mm,which was significantly smaller than that of the 1-4 toe,P ＜ 0.05.Conclusion The superficial layer of the plantar aponeurosis mainly participates in the formation of the anterolateral plantar fat pad;the deep layer of the plantar aponeurosis is crucial in maintaining the stability of the instep,which contributes to avoiding the compression of the common plantar digital nerves and the plantar vessels of toes when exerted with force.