Human Anatomy Teaching Group, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK.
Research Fellow in Academic Orthopaedics, Trauma and Sports Medicine, School of Medicine, University of Nottingham, Nottingham, UK.
Clin Anat. 2021 May;34(4):651-658. doi: 10.1002/ca.23686. Epub 2020 Oct 8.
Understanding the contribution of the fibularis longus tendon to the support of the midfoot arches has potential therapeutic applications. This cadaveric study sought to quantify this support across both the transverse arch and medial longitudinal arch and to establish whether a correlation exists between this support and the angle at which the tendon enters the sole.
Markers placed in 11 dissected cadaveric foot specimens defined the arch boundaries. Incremental weights up to 150 N were applied to the fibularis longus tendon to simulate progressive muscle contraction, and associated changes in the transverse and medial longitudinal arch boundaries were recorded.
A force of 150 N reduced the transverse arch distance by 4.6 (1.7) mm (mean [SD]) and medial longitudinal arch distance by 6.8 (1.4) mm. The angle of the fibularis longus tendon on the sole correlated well with changes in the transverse arch distance (slope ± s.e. = 0.56 ± 0.13 mm/degree, Pearson r = .83, p = .002) but only weakly with the medial longitudinal arch (0.18 ± 0.18 mm/degree, r = .32, p = .33).
The results of this preliminary study raise the possibility that physical therapies targeting the fibularis longus tendon may be valuable in the management of midfoot arch collapse. The correlation observed with the transverse arch suggests the possibility that surgical modification of the angle of the fibularis longus tendon on the sole may benefit patients with transverse arch collapse.
了解腓骨长肌腱对中足弓支撑的贡献具有潜在的治疗应用价值。这项尸体研究旨在定量评估该肌腱对横弓和内侧纵弓的支撑作用，并确定该支撑作用与肌腱进入足底的角度之间是否存在相关性。
在 11 个解剖的尸体足标本上放置标记物以定义弓的边界。在腓骨长肌腱上施加高达 150N 的增量重量，以模拟渐进性肌肉收缩，并记录横弓和内侧纵弓边界的相关变化。
150N 的力使横弓距离减少 4.6（1.7）mm（平均值[标准差]），使内侧纵弓距离减少 6.8（1.4）mm。腓骨长肌腱在足底的角度与横弓距离的变化密切相关（斜率[标准差]±0.13mm/度，Pearson r =.83，p =.002），但与内侧纵弓仅弱相关（0.18[0.18]mm/度，r =.32，p =.33）。
这项初步研究的结果提出了一种可能性，即针对腓骨长肌腱的物理治疗方法可能在中足弓塌陷的治疗中具有价值。与横弓的相关性表明，对足底腓骨长肌腱角度的手术修正可能使横弓塌陷的患者受益。
