跟内、外侧皮神经支的局部解剖与临床应用

Applied Anatomy and Chinical Application of Medial and Lateral Calcaneal Nerve Branches in the Treatment of Heel Pain

目的 :研究跟内、外侧皮神经支的体表定位及其与足跟痛的关系。方法 :解剖 2 0例足踝部尸体标本 ,分别以内、外踝尖水平线以及内、外踝尖与跟骨结节连线观测跟内、外侧皮神经支的体表定位。局部封闭跟内、外侧皮神经支治疗 3 5例足跟痛患者 ,以“治愈”、“有效”、“无效”标准进行评判疗效。结果 :跟内侧皮神经支体表定位 :内踝尖连接跟骨结节内侧突后最突出处连线中点的稍下方 ;跟外侧皮神经支体表定位 :外踝尖至跟腱后缘水平线中点稍下方 ;临床局部封闭跟内侧皮神经支治疗足跟痛的治愈率 81.3 % ,而封闭跟外侧皮神经支的治愈率为 4 1.7%。结论 :跟内侧皮神经支卡压是产生足跟痛的主要原因 ,局部封闭跟内侧皮神经支治疗足跟痛有良好效果。

Objective:To study the cutaneous sites of medial/lateral calcanean nerve branches and the relation between medial/lateral calcanean nerve branches and calcanneodynia.Methods:20 cadaver lower-leg specimens were anatomized and observed by two lines:one was the horizontas through the tip of malleolus medials/laterals,the other was the linking-line from the tip of malleolus medials/laterals to calcaneal tubercle.35 cases of calcanneodynia were treated by locally blocking in medial/lateral calcanean nerve branches and evaluated by the standard of 'cure,availability,invalidity'.Results:The cutaneous sites of medial calcanean nerve branches was below the midpoint of the linking-line between the tip of malleolus medials to calcaneal tubercle,the cure rate of locally blocking in medial calcanean nerve branches in treatment of heel-pain was 81.3%,but only 41.7% in lateral calcanean nerve branches.Conclusion It is the medial calcanean nerve branches that is the major factor to cause heel-pain,and it is efficient to treat calcanneodynia by locally blocking in medial calcanean nerve branches.