Anatomy and Biomechanical Properties of the Plantar Aponeurosis: A Cadaveric Study

Abstract

ObjectivesTo explore the anatomy of the plantar aponeurosis (PA) and its biomechanical effects on the first metatarsophalangeal (MTP) joint and foot arch.MethodsAnatomic parameters (length, width and thickness of each central PA bundle and the main body of the central part) were measured in 8 cadaveric specimens. The ratios of the length and width of each bundle to the length and width of the central part were used to describe these bundles. Six cadaveric specimens were used to measure the range of motion of the first MTP joint before and after releasing the first bundle of the PA. Another 6 specimens were used to evaluate simulated static weight-bearing. Changes in foot arch height and plantar pressure were measured before and after dividing the first bundle.ResultsThe average width and thickness of the origin of the central part at the calcaneal tubercle were 15.45 mm and 2.79 mm respectively. The ratio of the length of each bundle to the length of the central part was (from medial to lateral) 0.29, 0.30, 0.28, 0.25, and 0.27, respectively. Similarly, the ratio of the widths was 0.26, 0.25, 0.23, 0.19 and 0.17. The thickness of each bundle at the bifurcation of the PA into bundles was (from medial to lateral) 1.26 mm, 1.04 mm, 0.91 mm, 0.84 mm and 0.72 mm. The average dorsiflexion of the first MTP joint increased 10.16° after the first bundle was divided. Marked acute changes in the foot arch height and the plantar pressure were not observed after division.ConclusionsThe first PA bundle was not the longest, widest, or the thickest bundle. Releasing the first bundle increased the range of motion of the first MTP joint, but did not acutely change foot arch height or plantar pressure during static load testing.

Talonavicular ligament: prevalence of injury in ankle sprains, histological analysis and hypothesis of its biomechanical function

“…The PA divides in the forefoot into five bundles that connect the calcaneus to the proximal phalanges through the plantar plates, most importantly to the big toe. 17 When the big toe is extended, which is the position in which the big toe is in prior to the push-off of walking, the PA is pulled forward, with a consequent shortening and tightening that determines a rise of the longitudinal arch in a closed packed position.…”

Plantar aponeurosis features according to the results of anatomical research

“…За даними небагатьох дослідників, ПА складається з трьох окремих пучків [9,10]. Центральна порція починається від медіального відростка п'яткової горбистості, частину волокон отримує від ахіллового сухожилка [10].…”

“…Деякі автори вважають, що найширший центральний пучок і є істинним ПА. Зокрема, за інформацією з літератури, на рівні відходження від п'яткової кістки ширина центрального пучка в середньому дорівнює 12-29 мм [9][10][11]. Отримані нами дані щодо розмірів центрального пучка співпадають із результатами інших дослідників.…”

“…Товщина ентезису ПА, як ми визначили, у середньому становила (3,6 ± 1,9) мм, що дещо більше, ніж у дослідженні D. Chen і співавт. [9], за даними яких вона дорівнювала (2,79 ± 0,14) мм. Проте, отримані нами виміри не перевищували середні значення товщини ентезису ПА, опубліковані іншими дослідниками [9,12].…”

A prospective study of the muscle strength and reaction time of the quadriceps, hamstring, and gastrocnemius muscles in patients with plantar fasciitis

“…Plantar fasciitis (PF) is the most common problem involving foot pain. The causes of PF include excessive physical activities, [1] obesity, [2] age, [3] prolonged standing, [2] altered biomechanics, [4,5] limited ankle dorsi exion with foot postures such as pes cavus and pes planus, [6] and hamstring tightness. [7] Among them, limited ankle dorsi exion is caused by gastrocnemius (GCM) tightness, which may increase the stress to the plantar fascia because it affects the alignment of the calcaneal bone.…”