Rondhuis J J, Huson A
Department of Anatomy and Embryology, Leiden University, The Netherlands.
Acta Morphol Neerl Scand. 1986;24(4):269-79.
The course and ramification pattern of the lateral plantar nerve was studied in serial sections from 4 fetal feet and in dissections from 34 adult feet with special reference to the so called first branch. This branch was found in all of the observed fetal and adult specimen. From its originating point the nerve runs immediately distally to the medial process of the calcaneal tuberosity in a lateral direction to the proximal part of the abductor digiti minimi muscle. During its course the FB gives two branches. One of them penetrates sometimes the insertion of the quadratus plantae muscle, whereas in adult feet it always sends fibres to the periosteum around the medial process of the calcaneal tuberosity and the long plantar ligament. The other innervates the flexor digitorum brevis muscle. The site of a possible entrapment is located between the abductor hallucis muscle and the medial head of the quadratus plantae muscle. There is strong indirect evidence that the nerve is of a mixed type consisting of sensory fibres for the calcaneal periosteum and the medial head of the quadratus plantae muscle. There is strong indirect evidence that the nerve is of a mixed type consisting of sensory fibres for the calcaneal periosteum and the long plantar ligament as well as motor fibres for the quadratus plantae, flexor digitorum brevis and abductor digiti minimi muscles, which may explain the characteristic pain complaints of the heel pain syndrome. The occurrence of a stiff fascia perforated by the nerve branch or a bursa around the insertion of the plantar aponeurosis as has been described by several authors and which was put forward as a possible aetiological factor could not be confirmed in our material.
在4例胎儿足部的连续切片以及34例成人足部的解剖标本中，对足底外侧神经的走行和分支模式进行了研究，特别关注了所谓的第一分支。在所有观察到的胎儿和成人标本中均发现了该分支。该神经从其起始点立即向远侧走行至跟骨结节内侧突，呈外侧方向至小趾展肌近端。在其走行过程中，第一分支发出两支。其中一支有时穿过跖方肌的止点，而在成人足部，它总是向跟骨结节内侧突周围的骨膜和长跖韧带发出纤维。另一支支配趾短屈肌。可能的卡压部位位于拇展肌和跖方肌内侧头之间。有强有力的间接证据表明，该神经是一种混合型神经，由支配跟骨骨膜和跖方肌内侧头的感觉纤维组成。有强有力的间接证据表明，该神经是一种混合型神经，由支配跟骨骨膜和长跖韧带的感觉纤维以及支配跖方肌、趾短屈肌和小趾展肌的运动纤维组成，这可能解释了足跟痛综合征的典型疼痛症状。几位作者描述并提出可能作为病因的神经分支穿过僵硬的筋膜或跖腱膜止点周围的滑囊，在我们的材料中未能得到证实。
