背景:脚跟是一个复杂的解剖区域,通常是疼痛主诉的来源。鞋跟内侧包含许多结构,能够压缩该区域的主要神经并知道其解剖形貌是强制性的。这项工作的目的是评估胫神经(TN)及其主要分支是否与踝关节内侧的主要解剖标志有关,如果是,从TN出来后,他们有一条固定的道路吗?
方法:腿的远端部分,解剖了12具Thiel防腐尸体的脚踝和脚。记录TN分支的模式,并根据Dellon-McKinnon踝-跟骨线(DML)和Heimkes三角(HT)进行测量。
结果:TN接近DML的比例为87.5%,在DML的顶部有12.5%,在没有脚的远端。巴克斯特神经(BN)起源于近端的50%,在12,5%的DML之上,在37.5%的病例中远侧。DML的长度与从内踝(MM)中心到足底外侧神经(LPN)的距离之间存在强烈且显着的相关性,足底内侧(MPN)神经,BN和内侧跟骨神经(MCN)(ρ分别为0.910、0.866、0.970和0.762,p<0.001)。
结论:在我们的样本中,没有一个病例的TN分布在DML的远端。我们还报告了踝关节大小和MPN分布之间的强关联,LPN,BN和MCN。我们假设,如果我们考虑MM和跟骨结节的内侧过程之间的距离,这些分支在脚踝内侧的位置可能更可预测。
BACKGROUND: The heel is a complex anatomical region and is very often the source of pain complaints. The medial heel contains a number of structures, capable of compressing the main nerves of the region and knowing its anatomical topography is mandatory. The purpose of this work is to evaluate if tibial nerve (TN) and its main branches relate to the main anatomical landmarks of the ankle\'s medial side and if so, do they have a regular path after emerging from TN.
METHODS: The distal part of the legs, ankles and feet of 12 Thiel embalmed cadavers were dissected. The pattern of the branches of the TN was registered and the measurements were performed according to the Dellon-McKinnon malleolar-calcaneal line (DML) and the Heimkes Triangle (HT).
RESULTS: The TN divided proximal to DML in 87.5%, on top of the DML in 12,5% and distal in none of the feet. The Baxter\'s nerve (BN) originated proximally in 50%, on top of the DML in 12,5% and distally in 37.5% of the cases. There was a strong and significant correlation between the length of DML and the distance from the center of the medial malleolus (MM) to the lateral plantar nerve (LPN), medial plantar (MPN) nerve, BN and Medial Calcaneal Nerve (MCN) (ρ: 0.910, 0.866, 0.970 and 0.762 respectively, p < 0.001).
CONCLUSIONS: In our sample the TN divides distal to DML in none of the cases. We also report a strong association between ankle size and the distribution of the MPN, LPN, BN and MCN. We hypothesize that location of these branches on the medial side of the ankle could be more predictable if we take into consideration the distance between the MM and the medial process of the calcaneal tuberosity.