AYAĞIN MORFOMETRİK ÖZELLİKLERİNE GÖRE PLANTAR FASYA KALINLIĞININ DEĞERLENDİRİLMESİ

Yıl 2024, Cilt: 25 Sayı: 3, 295 - 299, 18.07.2024

Sinan Bakırcı Mahmut Çay Ali Yavuz Karahan

https://doi.org/10.18229/kocatepetip.1347953

Öz

AMAÇ: Çalışmamızda plantar fasya kalınlığı ile ayak morfometrik değerleri ve Aşil tendonu kalınlığı arasındaki ilişkinin incelenmesi amaçlandı.
GEREÇ VE YÖNTEM: Araştırma, aktif düzenli spor yapmayan genç gönüllüler üzerinde gerçekleştirildi. Toplamda 64 ayakta (17 erkek, 15 kadın) morfometrik ölçümler yapıldı. Ultrason görüntüsündeki plantar fasyanın kalınlığı ölçüldü. Ayak morfometrik değişkenleri olarak ayak uzunluğu, ayak genişliği, topuk genişliği ve ayak bileği çevresi kullanıldı.
BULGULAR: Genç sağlıklı erkek bireylerin %14,7'sinde plantar fasya kalınlığının 4 mm'den fazla olduğu belirlendi. Genç kadın bireylerin tamamında plantar fasya kalınlığının 3,6 mm'den küçük olduğu görüldü. Erkeklerde plantar fasya kalınlığı ile ayak uzunluğu ve ayak bileği çevresi uzunluğu arasında orta derecede pozitif korelasyon olduğu görüldü (p<0,05). Ancak plantar fasya kalınlığı ile ayak genişliği arasında herhangi bir korelasyonun olmaması dikkat çekiciydi. Tüm katılımcılar bir arada değerlendirildiğinde plantar fasya kalınlığı ile ayak uzunluğu, ayak bileği çevresi ve Aşil tendonu kalınlığı arasında orta düzeyde pozitif korelasyon bulunurken, ayak genişliği ve topuk çapı ile zayıf korelasyon bulundu (p<0,001).
SONUÇ: Farklı ırk ve coğrafi koşullara bağlı olarak ayak morfometrisi ve plantar fasya verilerinin literatüre eklenmesi anatomistlere ve antropologlara gerekli karşılaştırmaları yapma olanağı sağlamaktadır. Plantar fasiit tanısını desteklemek için kabul edilen “plantar fasya kalınlığının 4 mm'den büyük olması” hem erkekler hem de kadınlar için ayrı ayrı gözden geçirilmeli ve tartışılmalıdır

Anahtar Kelimeler

Plantar fasya, Aşil tendonu, Ayak, Morfoloji

EVALUATION OF PLANTAR FASCIA THICKNESS ACCORDING TO THE MORPHOMETRIC OF THE FOOT

Öz

OBJECTIVE: In our study, it was aimed to examine the relationship among plantar fascia thickness, foot morphometric values, and Achilles tendon thickness.
MATERIAL AND METHODS: The study was carried out on young volunteers who did not engage in any active regular sports. In total, morphometric measurements were performed on 64 feet (17 men, 15 women). The thickness of the plantar fascia on the ultrasound image was measured. Foot length, foot width, heel width, and ankle circumference were used as foot morphometric variables.
RESULTS: It was determined that the plantar fascia thickness was greater than 4 mm in 14.7% of young healthy male individuals. The plantar fascia thickness was found to be less than 3.6 mm in all young female individuals. In men, plantar fascia thickness was found to be moderately positively correlated with foot length and ankle circumference (p<0.05). However, it was interesting that there was no correlation between plantar fascia thickness and foot width. When all the participants were evaluated together, a moderate positive correlation was found between plantar fascia thickness and foot length, ankle circumference, and Achilles tendon thickness, while a weak correlation was found with foot width and heel diameter (p<0.001).
CONCLUSIONS: The addition of foot morphometry and plantar fascia data to the literature, depending on different racial and geographical conditions, allows anatomists and anthropologists to make necessary comparisons. To support the diagnosis of plantar fasciitis, the accepted “plantar fascia thickness greater than 4 mm” should be reviewed and discussed separately for both men and women.

Anahtar Kelimeler

Plantar fascia, Achilles tendon, Foot, Morphology

Teşekkür

Thanks to those who volunteered for the realization of the work.

Kaynakça

• 1. Fessel G, Jacob HA, Wyss C, et al. Changes in length of the plantar aponeurosis during the stance phase of gait--an in vivo dynamic fluoroscopic study. Ann Anat. 2014;196(6):471-8.
• 2. McKeon PO, Fourchet F. Freeing the foot: integrating the foot core system into rehabilitation for lower extremity injuries. Clin Sports Med. 2015;34(2):347-61.
• 3. Huang CK, Kitaoka HB, An KN, et al. Biomechanical evaluation of longitudinal arch stability. Foot & ankle. 1993;14(6):353-7.
• 4. Kitaoka HB, Luo ZP, An KN. Effect of plantar fasciotomy on stability of arch of foot. Clin Orthop Relat Res. 1997;344:307-12.
• 5. Thordason DB, Hedman T, Lundquist D, et al. Effect of calcaneal osteotomy and plantar fasciotomy on arch configuration in a flatfoot model. Foot & ankle Int. 1998;19(6):374-8.
• 6. Gefen A. Stress analysis of the standing foot following surgical plantar fascia release. J Biomech. 2002;35(5):629-37.
• 7. Cheung JTM, Zhang M, An KN. Effects of plantar fascia stiffness on the biomechanical responses of the anklefoot complex. Clin Biomech. 2004;19(8):839-46.
• 8. Erdemir A, Hamel AJ, Fauth AR, et al. Dynamic loading of the plantar aponeurosis in walking. JBJS. 2004;86(3):546-52.
• 9. Józsa L, Kvist M, Bálint BJ, et al. The role of recreational sport activity in Achilles ten-don rupture. A clinical, pathoanatomical, and sociological study of 292 cases. Am J Sports Med. 1989;17(3):338-43.
• 10. Huerta JP. The effect of the gastrocnemius on the plantar fascia. Foot Ankle Clin. 2014; 19(4):701-18.
• 11. Canbolat M. A Study of Morphometric Charateristics of Achilles Tendon by Using Ultrasound Imaging Over 18 Years Old Healty Population. Inonu University, Faculty of Medicine, Department of Anatomy, Doctoral Thesis, Malatya, Turkey 2015.
• 12. Cohen J. Statistical power analysis for the behavioral sciences. Academic press. 2013.
• 13. Abul K, Ozer D, Sakizlioglu SS, et al. Detection of normal plantar fascia thickness in adults via the ultrasonographic method. Journal of the American Podiatric Medical Association. 2015;105(1):8-13.
• 14. McMillan A, Landorf K, Barrett J, et al. Diagnostic imaging for chronic plantar heel pain: a systematic review and meta-analysis. J Foot Ankle Res. 2011;4:1.
• 15. Karabay N, Toros T, Hurel C. Ultrasonographic evaluation in plantar fasciitis. J Foot Ankle Surg. 2007;46(6):442-6.
• 16. Gadalla N, Kichouh M, Boulet C, et al. Sonographic evaluation of the plantar fascia in asymptomatic subjects. Journal of the Belgian Society of Radiology. 2014;97(5):271-3.
• 17. Wall JR, Harkness MA, Crawford A. Ultrasound diagnosis of plantar fasciitis. Foot & Ankle. 1993;14(8):465-70.
• 18. Stecco C, Corradin M, Macchi V, et al. Plantar fascia anatomy and its relationship with Achilles tendon and paratenon. Journal of Anatomy. 2013;223(6):665-76.
• 19. Bohm S, Mersmann F, Marzilger M, et al. Asymmetry of Achilles tendon mechanical and morphological properties between both legs. Scand J Med Sci Sports. 2015;25:124–32.
• 20. Ogugua AE, Chukwudi OO, Salami E, et al. Normal thickness of the tendo calcaneus (TCT) in an adult Nigerian population: An imaging based normographic study. British Journal of Medicine & Medical Research. 2014;4(10):2100-11.