Anatomy of Aponeurosis Plantaris and topographic relationship with lateral Plantar nerve

Objectives: Our study is done for having a better understanding of the anatomy of aponeurosis plantaris, including the topographic relationship of it to the lateral plantar nerve, aiming to shed light on the anatomic, biomechanic and surgical features. Methods: This study, a total of 20 adult male cadaveric feet including in the right and left legs with no pathology. 21 parameters were determined and cadavers were prepared for measurements. These measurements; 1. The length and width of the foot, 2. The thickness and width of the aponeurosis plantaris, 3. The distance from the tuber calcanei, to the 1st, 2nd and 5th caput metatarsale, 4. The distance from the medial and lateral malleoles of the ankle to the sole of the foot was measured, 5. The distance from the medial and lateral entrance and exit points of lateral plantar nerve to aponeurosis plantaris, 6. The distance between the entrance and exit points of lateral plantar nerve vein aponeurosis plantaris with tuber calcanei, 7. The distance from the point of entry of the aponeurosis plantaris to the starting point of lateral plantar nerve, 8. The distance from the aponeurosis plantaris to the distance line (C length) between the tuber calcanei and the 5th caput metatarsale horizontally: distance Y, 9. Distance from tuber calcanei to the length of Y line C length: X length were measured. Measurements were made by digital compass, tape measure and goniometer. Result: Foot length 25,06 ± 1,05 cm, width of the widest part of the foot 92,48 ± 4,89 mm, transverse width of the foot base on the transverse plane between the points where the medial and lateral malleolus vertical axes cut horizontal plane 64,27 ± 3,83 mm, the thickness and width of the aponeurosis plantaris on the tuber calcanei is 3,29 ± 0,42 mm and 13,05 ± 1,69 mm, maximum width of the aponeurosis plantaris close to the origin of the bundles 34,11 ± 2,72 mm, the distance between 1st and 5th caput metatarsales is 73,00 ± 3,06 mm, the distance between the tuber calcanei and the 1, 2 and 5th caput metatarsals was 140,03 ± 6,14 mm, 143,95 ± 6,98 mm and 131,58 ± 5,73 mm, respectively. The distances between the medial and lateral malleol and the soles of the feet were calculated as 78,40 ± 4,14 mm and 71,68 ± 5,20 mm. The mean values in the measurements of lateral plantar nerve; the medial and lateral distances of the entrance point of lateral plantar nerve to aponeurosis plantaris are 18,39 ± 1,11 mm and 48,44 ± 1,70 mm, the distance from the aponeurosis plantaris to the medial and the lateral distance to the exit point is 49,70 ± 1,85 mm and 35,44 ± 1,44 mm, the distances between the entrance and exit points of lateral plantar nerve in aponeurosis plantaris with tuber calcanei 31,33 ± 1,83 mm and 70,57 ± 2,44 mm, the distance between the starting point and the starting point of the aponeurosis plantaris is 33.52 ± 3.43 mm, the horizontal distance of X from the aponeurosis plantaris to the C line of the exit point (distance between the tuber calcanei and the 5th caput metatarsale): Y length 18,25 ± 1,79 mm, the distance between the point where the length C of the Y line cuts and the tuber calcanei: The length X is calculated as 87,07 ± 2,15 mm. Conclusion: The aim of this study was to detail the morphometric measurements of aponeurosis plantaris and the topographic relationship to lateral plantar nerve. We hope that our study will contribute to literature releated endoscopic plantar fasciatomy and lateral plantar nerve release surgery risk reduction by defining the dangerous area and will shed light on clinicians. Keywords: plantar fascia; lateral plantar nerve; aponeurosis plantaris