Tang Juyu, Li Kanghua, Ren Jiawu, Liu Jun, Liu Yangbo, Luo Lin
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2010 Apr;35(4):386-9. doi: 10.3969/j.issn.1672-7347.2010.04.019.
To provide anatomic evidence for choosing medial calcaneal nerve(MCN ) as recipient cutaneous nerve to rebuild heel sensation.
We chose 20 adult cadavers' lower limbs, dissected the MCNs, observed their original sites, shapes, courses and distribution, and measured the perpendicular distance from original sites of MCNs from tibial nerve, original sites of their branches to the tip of medial malleolus, and the external diameters of their main trunks and branches.
The frequency of the MCN was 95% in this array. All the MCNs arose from the tibial nerve at 3.3 cm up the horizontal plane of the tip of medial malleolus. They sent out anterior branches and posterior branches from 0.3 cm below the horizontal plane of the tip of medial malleolus on average. The anterior branch dominated the cutaneous sensation of the anterior part of the medial calcaneal and heel weight loading field, while the posterior branch dominated the sensation of the posterior and median part. The shape of MCNs, main trunks, anterior branches and posterior branches was like circular cylinder. At the origination, the external diameter of the MCN, the anterior branch and the posterior branch was 1.58, 1.13 and 0.90 mm on average, respectively.
The anatomical position of MCN is relatively constant, and its external diameter is suitable. The initiation is not close to the heel weight loading area. Its anatomic characteristics meet the requirements of sensation recovery of the heel, especially the heel weight loading field.
为选择跟内侧神经(MCN)作为受区皮神经重建足跟感觉提供解剖学依据。
选取20具成人尸体下肢,解剖跟内侧神经,观察其起始部位、形态、走行及分布,并测量跟内侧神经自胫神经发出处、其分支起始处至内踝尖的垂直距离,以及其主干和分支的外径。
该组中跟内侧神经出现率为95%。所有跟内侧神经均在内踝尖水平面上方3.3 cm处由胫神经发出。它们平均在内踝尖水平面下方0.3 cm处发出前支和后支。前支支配跟内侧前部及足跟负重区的皮肤感觉,而后支支配后部及中部的感觉。跟内侧神经及其主干、前支和后支的形态均呈圆柱状。起始处跟内侧神经、前支和后支的外径平均分别为1.58、1.13和0.90 mm。
跟内侧神经的解剖位置相对恒定,外径适宜。起始处不靠近足跟负重区。其解剖学特点符合足跟尤其是足跟负重区感觉恢复的要求。