Zhao Xin-Yue, Zhao Hong-Wei, Yu Miao, Zheng Ze-Hua, Tang Yun, Cui Miao-Miao, Sun Xue-Yu, Qin Xiang-Zheng, Liu Yan-Qun
Undergraduate, Clinical Medicine, Medical College of Yanbian University, Yanji, Jilin Province, China.
Associate Professor, Department of Anatomy, Medical College of Yanbian University, Yanji, Jilin Province, China.
J Foot Ankle Surg. 2019 Nov;58(6):1235-1244. doi: 10.1053/j.jfas.2018.09.032. Epub 2019 Sep 5.
The purposes of this study were to integrate the types of interconnecting fibers among components of the chiasma plantare and to deduce their flexion actions. The chiasma plantare and the long flexor tendons in 52 cadaveric feet (26 left feet and 25 right feet) were dissected and removed via gross anatomic dissection. The connections among the flexor digitorum longus (FDL), flexor hallucis longus (FHL), and quadratus plantae (QP) were then classified and analyzed. The connection between the FHL and FDL was type I in 43 (86%) cases, type III in 2 (4%) cases, and type V in 5 (10%) cases, with the FHL manipulating the first through third toes and the FDL manipulating the first through the fifth toes. The shape of the QP in 28 (56%) cases exhibited a 2-headed QP, and in 22 (44%) cases, a medial-headed QP. The composition of the chiasma plantare was 2 layers in 28 (56%) cases and 3 layers in 22 (44%) cases: 9 (18%) cases were type a, 2 (4%) cases were type b, and 1 (2%) case each was classified as type b and b. The FHL controlled the second toe in 10 (20%) cases; both the second and third toes in 27 (54%) cases; and the second, third, and fourth toes in 13 (26%) cases. The QP manipulated the third and fourth toes in all cases, the second toe in 38 (76%) cases, and the fifth toe in 11 (22%) cases. These data suggest that such variations might result from tendon transfer. In conclusion, we considered the FDL to be more advanced for the recovery of both the ankle and the forefoot based on this study.
本研究的目的是整合足底交叉各组成部分之间的连接纤维类型，并推断其屈曲作用。通过大体解剖，对52例尸体足（26例左脚和25例右脚）的足底交叉和长屈肌腱进行解剖并移除。然后对趾长屈肌（FDL）、拇长屈肌（FHL）和跖方肌（QP）之间的连接进行分类和分析。FHL与FDL的连接在43例（86%）中为I型，2例（4%）中为III型，5例（10%）中为V型，其中FHL控制第一至第三趾，FDL控制第一至第五趾。28例（56%）的QP形状为双头QP，22例（44%）为内侧头QP。足底交叉的组成在28例（56%）中为2层，22例（44%）中为3层：9例（18%）为a型，2例（4%）为b型，各有1例（2%）被分类为b型和b型。FHL在10例（20%）中控制第二趾；在27例（54%）中控制第二和第三趾；在13例（26%）中控制第二、第三和第四趾。QP在所有病例中控制第三和第四趾，在38例（76%）中控制第二趾，在11例（22%）中控制第五趾。这些数据表明，此类变异可能是肌腱转移所致。总之，基于本研究，我们认为FDL在踝关节和前足的恢复方面更为先进。
