Department of Anatomy, Centre of Biostructure Research, Medical University of Warsaw, Poland.
Ann Anat. 2009 Dec;191(6):586-93. doi: 10.1016/j.aanat.2009.07.006. Epub 2009 Aug 20.
The Achilles or calcaneal tendon is the structural base for the biomechanical work of the ankle joint. The purpose of this study is to describe the internal structure of the human Achilles tendon. The anatomy of the Achilles tendon has been described in lower mammals in which it has three parts which can be dissected from its beginning to the insertion onto the calcaneus. The partial ruptures of each part suggest that the human Achilles tendon may also be composed of parts. The Achilles tendon is one of the most commonly torn tendons in the human body. Each segment of the Achilles tendon described by us can be ruptured separately, which can cause a partial dysfunction in flexion of the ankle joint as observed in clinical practice. We dissected 20 Achilles tendons previously fixed in 10% formaldehyde and 20 fresh-frozen Achilles tendons, paying particular attention to the relationship between the lateral and medial heads of the gastrocnemius and the soleus muscles. The layer-by-layer method and a microscope were used in our study. We found that the medial group of fibers from the medial head of the gastrocnemius muscle constitutes the posterior layer of the tendon. The lateral border of the tendon is composed of the fibers from the lateral part of the medial head of the gastrocnemius muscle. The fibers from the lateral head of the gastrocnemius muscle constitute the anterior layer of the Achilles tendon. The fibers from the soleus muscle are located in the anteromedial part of the Achilles tendon. Our findings are supported by clinical descriptions and observations of the partial rupture of the Achilles tendon.
跟腱是踝关节生物力学工作的结构基础。本研究旨在描述人类跟腱的内部结构。在较低等哺乳动物中，跟腱有三个部分，可以从起点一直解剖到跟骨附着处。各部分的部分撕裂表明人类跟腱可能也由多个部分组成。跟腱是人体最常撕裂的肌腱之一。我们描述的跟腱的每个节段都可以单独撕裂，这可能导致临床上观察到的踝关节背屈功能部分丧失。我们解剖了 20 个以前用 10%甲醛固定的跟腱和 20 个新鲜冷冻的跟腱，特别注意观察比目鱼肌和腓肠肌内侧头和外侧头之间的关系。我们的研究采用了逐层法和显微镜。我们发现，来自比目鱼肌内侧头的内侧纤维群构成了肌腱的后层。肌腱的外侧边界由比目鱼肌内侧头外侧部分的纤维组成。腓肠肌外侧头的纤维构成跟腱的前层。比目鱼肌的纤维位于跟腱的前内侧部分。我们的发现得到了临床描述和跟腱部分撕裂观察的支持。
