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Aponeurosis plantaris and its relationship to forefoot deformities

Publication at First Faculty of Medicine |
2016

Abstract

Aponeurosis plantaris is an important structure in the forefoot. The spatial arrangement of its parts is important in maintaining the stability of the foot.

In this article, we decided to highlight some important aspects relating to the anatomy of plantar aponeurosis and biomechanics resulting from them. In our study, a total of 20 specimens of metatarsophalangeal articulation in 12 cadavers was included.

Special attention was then devoted to the arrangement of the distal part of the plantar aponeurosis, sagittal septum that was clamped into the plantar discs and each individual metatarsophalangeal articulation. The samples came from 8 women and 4 men.

All samples always had present and fully developed streaks in the central portion, medial and lateral parts. In all cases, distal stripes on the central part in the dermis were developed, curving into the interdigital spaces.

Stripes on the distal part were highly variable and their edges faded into the hypodermic tissue. By summarising the various widths and orientations of the distal bands a reconstruction and a scheme were constructed.

The complex aponeurosis plantaris and its associated structures form an important functional unit, which is the basis for the functioning of the stabilization mechanism of the legs, the so-called windlass mechanism. Many authors deal with the role of plantar aponeurosis in the development of some pathologies of the first ray of the foot.

Across the literature, there is a consensus on the importance of restoring physiological conditions during surgical treatment of the most common deformities of the first ray, such as hallux valgus and hallux rigidus. The distal part of the plantar aponeurosis creates a spatial network, which serves not only to maintain the correct position of the bones of the legs, but also as an anchor for the sole of the foot.

Malfunctions to the aponeurosis plantaris lead to foot deformities such as hallux valgus or hallux rigidus.