跟外侧神经与神经源性跟痛症关系的解剖学基础

Anatomical foundation of the relationship between the lateral calcaneal nerve and neurogenic painful heel syndrome

目的探讨跟外侧神经的局部解剖特点及其与神经源性跟痛症的关系,为临床诊断治疗提供解剖学依据。方法 32侧防腐成人尸体下肢标本,解剖观察跟外侧神经的起源、分支、走行和分布特点。结果跟外侧神经均起自于腓肠神经,9.38%以单干的形式出现,28.13%为双干,43.75%为3干,18.75%为4干。神经分布于足跟外侧及跟底外侧1/3的皮肤和跟垫组织以及骨膜。结论跟外侧神经在跟管内和覆盖于小趾展肌表面的足底腱膜外侧部的锐利缘处均有可能被卡压而引发神经源性跟痛症。

Objective To investigate the relationship between the lateral calcaneal nerve（LCN） and the neurogenic painful heel syndrome （NPHS） and provide anatomicalevidence for its study, diagnosis and therapy. Methods 32 sides formalin-fixed adult lower-limb specimens were used in the study. LCN was dissected to observe its origin,course, branches and distribution. Results In all cases, the LCN originated from the sural nerve. They existed in the form of a single principal trunk in 9.38% of cases,double trunks in 28.13%, three trunks in 43.75% and four trunks in 18.75%. They innervated the skin, the fat pad and the periosteum on the lateral calcaneus and the lateral onethird of the plantar calcaneus. Conclusions The LCN can be compressed in the calcaneal tunnel and at the sharp border where the LCN run through the superficial layer of the lateral part of the plantar aponeurosis and the compression, leading to possible occurrence of NPHS.