Sectional anatomy of connective tissue structures in the hindfoot of the newborn child and the adult.

Abstract

The knowledge of the normal anatomy of the newborn hindfoot is essential for the understanding of foot deformities. In the present study, we investigated tendons, ligaments, and soft tissue structures in the newborn foot. The sectional anatomy of eight newborn feet was studied in 300-500-microns-thick sections processed by plastination histology. For comparison, 3-5-mm-thick plastinated sheets of adult feet were investigated. Our specimens show obvious differences of the newborn compared with the adult foot. In the subcutaneous adipose tissue, the heel pad and the fat pad of the Achilles tendon and the relative size and topography of adipose tissue pads are different. Moreover, the course of the flexor hallucis tendon and the insertion pattern of the Achilles tendon are distinct. Finally, there are differences in the course and in the relative length of some plantar ligaments. Our data reveal that the differences between the newborn foot and the adult foot result mainly from the different shape and position of the tarsal bones. Our findings are of clinical importance for the evaluation of magnetic resonance imaging in the normal infant's foot and in foot deformities.