小趾展肌神经与神经源性跟痛症关系的解剖学基础

目的　探讨小趾展肌神经的局部解剖特点及其与神经源性跟痛症的关系，为临床诊断治疗提供解剖学依据。 方法　32侧防腐成人尸体下肢标本，解剖观察小趾展肌神经的起源、分支、走行和分布特点。 结果　小趾展肌神经81.25%起源于足底外侧神经，起点59.38%位于后上象限；起点与参考线的垂直深度，左侧（10.81±0.96）mm，右侧（10.24±1.10）mm；小趾展肌神经发出1～3支骨膜支到达跟骨结节内侧突的骨膜；小趾展肌神经与跟骨结节内侧突该的水平距离左侧（19.95±1.82）mm，右侧（20.89±2.48）　mm 。 结论　小趾展肌神经行经　展肌和足底方肌内侧头之间,跟骨结节内侧突前可能被卡压，卡压或病变（特别是骨膜支）可能与足底腱膜炎发生有关；跟骨骨刺不一定会造成神经源性跟痛症。

Anatomic relationship of abductor digiti miniini nerve and neuragenic painful heel syndrome

Objective To investigate anatomic relationship between abductor digiti minimi nerve(ADMN) and neurogenic painful heel syndrome(NPHS) for clinical diagnosis and therapy.Methods 32 fixed adult lower limb specimens were used in the study.The ADMN was dissected for observing it’s origin,course,branches and distribution.Results For cases of 81.25%,ADMN originated from the lateral plantar nerve,which consisted of 19 trunks(59.38%) located in the posterosuperior quadrant.The vertical depth of the origin site to the reference line was(10.81±0.96)mm and(10.24±1.10) mm at left and right sides respectively.ADMN firstly issued 1~3 periosteum branches,which arrived the periosteum of medial process of calcaneal tuberosity.The horizontal distances from the site of medial process of calcaneal tuberosity to the left or right tuberosities were(19.95±1.82) mm and(20.89±2.48)mm,seperately.Conclusions ADMN is probably stamped when it goes through the abductor hallucis,the medial head of quadratus plantae and the medial process of calcaneal tuberosity.The stamp or lesion of ADMN(especially periosteum branch) is probably related to the occurrence of the plantar fasciitis.The calcaneus spur doesn’t always cause the NPHS.