跟内侧神经与神经源性跟痛症关系的解剖学基础  

Medial calcaneal nerve and neurogenic painful heel syndrome:anatomic basis

作　　者：冯成安[1] 孙俊[1] 刘宗良[1] 范炜[1] 张东葵[1] 叶频[1] 

机构地区：[1]昆明医科大学人体解剖学与组织胚胎学系,昆明650500

出　　处：《中国临床解剖学杂志》2012年第5期491-493,497,共4页Chinese Journal of Clinical Anatomy

基　　金：云南省教育厅科学研究基金项目(2010C153)

摘　　要：目的探讨跟内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,解剖观察跟内侧神经的起源、分支、走行和分布特点。结果跟内侧神经41.42%起源于胫神经,28.57%起源于胫神经分叉处,18.57%起源于足底内侧神经,11.42%起源于足底外侧神经。起点距O点(内踝尖最下缘与跟骨结节内侧突连线中点)(30.22±15.34)mm。跟内侧神经穿出屈肌支持带后分布于足跟内侧及跟底的皮肤和跟垫组织。结论跟内侧神经在踝管内,浅出屈肌支持带处及跟管内可能被卡压;神经卡压或病变可能与足底腱膜炎发生及疼痛有关。Objective To investigate the relationship between the medial calcaneal nerve （MCN） and neurogenic painful heel syndrome （NPHS）, and provide anatomical evidence for study, diagnosis and therapy. Methods 32 formalin-fixed adult lower limb specimens were used in the study. MCN was dissected for demonstrating the origin, course, branches and the distribution. Results 41.42% of MCN originated from the trunk of tibial nerve, however, 28.57% originated from the bifurcation site of tibial nerve, 18.57% from the medial plantar nerve, and 11.42% from the lateral plantar nerve. The distance from the origin of MCN to the middle point between the lowest margin of the medial malleolus and the medial process of calcaneal tuberosity was about （30.22±15.34）mm. MCN distributed to medial heel, the skin of foot-plate, and soft tissue of heel, after passing through flexor retinaculum. Conclusions MCN maybe compressed in the ankle canal, or the calcaneal tunnel, or at the site of passing from the flexor retinaculum, which are probably related to the occurrence of the plantar fasciitis and heel pain.

关 键 词：跟内侧神经 神经源性跟痛症 应用解剖 

分 类 号：R323.72[医药卫生—人体解剖和组织胚胎学]