Center for Anatomical Sciences, University of North Texas Health Science Center, Fort Worth, TX, USA.
Department of Orthopaedic Surgery, John Peter Smith Hospital, Fort Worth, TX, USA.
Foot Ankle Int. 2019 Nov;40(11):1325-1330. doi: 10.1177/1071100719864352. Epub 2019 Aug 6.
We describe a thick fascial band arising from the medial aspect of the lateral plantar aponeurosis diving deep into the forefoot crossing over a branch of the lateral plantar nerve. Because a review of current literature resulted in limited and outdated sources, we sought to first determine the frequency of this fascial band and the location where it crosses the lateral plantar nerve and, second, discuss the clinical applications these anatomical findings could have.
50 pairs of cadaveric feet (n = 100) were dissected to investigate for presence of the fascial band and its interaction with the lateral plantar nerve. Images were taken of each foot with the fascial band. ImageJ was used to take 2 measurements assessing the relationship of the tuberosity of the base of the fifth metatarsal to where the nerve crossed deep to the fascial band.
Overall, 38% of the feet possessed the fascial band. It was found unilaterally in 10 pairs and bilaterally in 14 pairs. On average, the point at which the lateral plantar nerve passed deep to the fascial band was 2.0 cm medial and 1.7 cm anterior to the tuberosity of the base of the fifth metatarsal.
When present, the deep band of the lateral plantar aponeurosis (PA) was consistently found to be crossing the lateral plantar nerve. The discovery of the location where this most commonly occurs has not been previously reported and adds an interesting dimension that elevates an anatomical study to one that has clinical potential.
The established target zone gives a precise location for where the relationship between the deep band of the lateral PA and the lateral plantar nerve exists when evaluating the foot. The target zone provides a potential springboard for future investigations concerning said relationship clinically.
我们描述了一条从外侧足底筋膜的内侧部分起始的厚筋膜带，深入前足，跨越外侧足底神经的分支。由于对当前文献的回顾导致来源有限且过时，我们首先试图确定这条筋膜带的出现频率以及它穿过外侧足底神经的位置，其次讨论这些解剖学发现可能具有的临床应用。
对 50 对尸体足（n = 100）进行解剖，以调查筋膜带的存在及其与外侧足底神经的相互作用。对每只脚的筋膜带进行拍照。使用 ImageJ 对图像进行处理，测量评估第五跖骨基底结节与神经穿过深筋膜带之间的关系的 2 个指标。
总体而言，38%的足存在筋膜带。在 10 对足中发现单侧存在，在 14 对足中发现双侧存在。平均而言，外侧足底神经穿过深筋膜带的位置位于第五跖骨基底结节内侧 2.0cm 和前 1.7cm。
当存在时，外侧足底筋膜的深部带（PA）始终被发现穿过外侧足底神经。此处最常见的交叉点的发现以前没有报道过，增加了一个有趣的维度，将解剖学研究提升到具有临床潜力的研究。
当评估足部时，确定了外侧 PA 深部带与外侧足底神经之间关系的目标区域，提供了一个精确的位置。该目标区域为未来有关所述关系的临床研究提供了一个潜在的跳板。
