Defining Potential Neurovascular Risk Zones in Superficial Plantar-Medial Release: An Anatomical Study

Area of Science:

• Anatomy
• Orthopedic Surgery
• Podiatry

Background:

• Superficial plantar-medial release (S-PMR) addresses plantar fasciitis and cavovarus foot deformities.
• The procedure targets plantar aponeurosis and intrinsic muscle contractures contributing to foot instability.
• Variable neurovascular structures in the plantar region necessitate precise anatomical understanding for safe S-PMR.

Purpose of the Study:

• To define procedure-specific anatomical
• high-risk
• and
• low-risk
• zones for superficial plantar-medial release.
• To analyze the anatomical variability of the plantar aponeurosis and associated neurovascular structures.

Main Methods:

• Analysis of 41 human foot specimens.
• Detailed examination of the plantar aponeurosis, abductor hallucis muscle origins, and regional neurovascular bundles.
• Measurement of distances between key anatomical landmarks.

Main Results:

• Abductor hallucis origins I and IV were consistently present; origins II and III showed variability.
• The medial calcaneal nerve was closely associated with abductor hallucis origin I (3.2 mm).
• Medial and lateral plantar nerves were proximate to abductor hallucis origin II (3 mm and 5.3 mm).

Conclusions:

• Significant interindividual anatomical variability in the plantar region mandates personalized surgical approaches.
• Identified
• high-risk
• zones include the area between abductor hallucis origin I and the medial calcaneal nerve, and near origin II.
• Defined
• low-risk
• zones are dorsal calcaneal regions and medial areas near the malleolus.