On the morphological relations of the Achilles tendon and plantar fascia via the calcaneus: a cadaveric study.
On the morphological relations of the Achilles tendon and plantar fascia via the calcaneus: a cadaveric study.
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DOI：
10.1038/s41598-021-85251-0
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发表时间：
2021-03-16
影响因子：
4.6
通讯作者：
Hammer N
中科院分区：
文献类型：
--
作者：
Singh A;Zwirner J;Templer F;Kieser D;Klima S;Hammer N
目前足底筋膜炎的治疗是基于跟腱（AT）和足底筋膜（PF）机械直接连接的前提，这是一个有争议的领域。本研究的目的是评估AT和PF之间的形态学关系。19具尸体足进行X线成像，连续切片和塑化数字图像分析。在跟骨止点测量AT和PF厚度和横截面积（CSA）。在代表性子样本中对纤维连续性进行组织学评估。AT和PF跟骨止点CSA与PF止点长度CSA之间存在较强的相关性（r = 0.80），AT和PF止点长度CSA之间也存在较强的相关性。AT和PF厚度之间观察到进一步的相关性（r = 0.62）。然而，这种密切的形态学关系不能通过X线证实，也不能通过组织学中的完全纤维连续性证实。这项研究提供了证据的AT和PF之间的形态关系，这表明这两个结构之间的功能关系的存在下，生物学的关键思想，即结构决定功能。所观察到的形态学相关性证实了AT和PF之间通过跟骨后部的现有机械联系，并可能解释为什么小腿拉伸是足跟痛的成功治疗选择。
Current treatments of plantar fasciitis are based on the premise that the Achilles tendon (AT) and plantar fascia (PF) are mechanically directly linked, which is an area of debate. The aim of this study was to assess the morphological relationship between the AT and PF. Nineteen cadaveric feet were x-ray imaged, serially sectioned and plastinated for digital image analyses. Measurements of the AT and PF thicknesses and cross-sectional areas (CSA) were performed at their calcaneal insertion. The fiber continuity was histologically assessed in representative subsamples. Strong correlations exist between the CSA of the AT and PF at calcaneal insertion and the CSA of PF’s insertional length (r = 0.80), and between the CSAs of AT’s and PF’s insertional lengths. Further correlations were observed between AT and PF thicknesses (r = 0.62). This close morphological relationship could, however, not be confirmed through x-ray nor complete fiber continuity in histology. This study provides evidence for a morphometric relationship between the AT and PF, which suggests the presence of a functional relationship between these two structures following the biological key idea that the structure determines the function. The observed morphological correlations substantiate the existing mechanical link between the AT and PF via the posterior calcaneus and might explain why calf stretches are a successful treatment option for plantar heel pain.
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