Theobald P, Bydder G, Dent C, Nokes L, Pugh N, Benjamin M
Institute of Medical Engineering and Medical Physics, Cardiff University, UK.
J Anat. 2006 Jan;208(1):91-7. doi: 10.1111/j.1469-7580.2006.00510.x.
Kager's fat pad is a mass of adipose tissue occupying Kager's triangle. By means of a combined magnetic resonance imaging, ultrasound, gross anatomical and histological study, we show that it has three regions that are closely related to the sides of the triangle. Thus, it has parts related to the Achilles and flexor hallucis longus (FHL) tendons and a wedge of fat adjacent to the calcaneus. The calcaneal wedge moves into the bursa during plantarflexion, as a consequence of both an upward displacement of the calcaneus relative to the wedge and a downward displacement of the wedge relative to the calcaneus. During dorsiflexion, the bursal wedge is retracted. The movements are promoted by the tapering shape of the bursal wedge and by its deep synovial infolds. Fibrous connections linking the fat to the Achilles tendon anchor and stabilize it proximally and thus contribute to the motility of its tip. We conclude that the three regions of Kager's fat pad have specialized functions: an FHL part which contributes to moving the bursal wedge during plantarflexion, an Achilles part which protects blood vessels entering this tendon, and a bursal wedge which we suggest minimizes pressure changes in the bursa. All three regions contribute to reducing the risk of tendon kinking and each may be implicated in heel pain syndromes.
卡格脂肪垫是占据卡格三角的一团脂肪组织。通过磁共振成像、超声、大体解剖学和组织学的联合研究，我们发现它有三个与三角形各边密切相关的区域。因此，它有与跟腱和拇长屈肌腱（FHL）相关的部分以及与跟骨相邻的一块楔形脂肪。在跖屈时，由于跟骨相对于楔形脂肪向上移位以及楔形脂肪相对于跟骨向下移位，跟骨楔形脂肪移入滑囊。在背屈时，滑囊楔形脂肪回缩。这些运动由滑囊楔形脂肪的锥形形状及其深部滑膜皱襞推动。将脂肪与跟腱相连的纤维连接在近端固定并稳定跟腱，从而有助于跟腱末端的活动。我们得出结论，卡格脂肪垫的三个区域具有特殊功能：一个FHL部分，在跖屈时有助于移动滑囊楔形脂肪；一个跟腱部分，保护进入该肌腱的血管；一个滑囊楔形脂肪，我们认为它可使滑囊内的压力变化最小化。所有这三个区域都有助于降低肌腱扭结的风险，并且每个区域都可能与足跟疼痛综合征有关。
