Lateral Plantar Nerve Release with or without Calcaneal Drilling for Resistant Plantar Fasciitis

Sadek, Ahmed Fathy; Fouly, Ezzat H.; Elian, Mostafa Mohamed Mostafa

doi:10.1177/230949901502300226

Cited by 9 publications

(15 citation statements)

References 29 publications

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“…The superficial abductor fascia should be released and the abductor T. H. LUI hallucis muscle should be mobilized before the deep abductor fascia can be released. 1,5,24,25 The endoscopic technique of nerve decompression is a feasible alternative with the advantage that the deep abductor fascia can be released without the need of extensive dissection. 6 The 2 portals are coaxial and located at the plantar and dorsal margins of the deep abductor fascia.…”

Section: Discussionmentioning

confidence: 99%

“…4 The structures around the medial calcaneal tubercle can be viewed through the dorsal portal. Procedures of these structures, for example, endoscopic plantar fascia release, removal of calcaneal spur, 18 and drilling of the calcaneus, 25 can be performed through the plantar portal if recalcitrant plantar fasciitis is also present ( Table 1). 26 The major advantage of this technique compared with other endoscopic techniques is that the entrapment of the first branch of lateral plantar nerve can be dealt together with endoscopic release of the plantar aponeurosis.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic Decompression of the First Branch of the Lateral Plantar Nerve and Release of the Plantar Aponeurosis for Chronic Heel Pain

Lui¹

2016

Arthroscopy Techniques

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Entrapment of the first branch of the lateral plantar nerve is a commonly missed cause of recalcitrant plantar heel pain. The diagnosis is made on a clinical ground with maximal tenderness at the site of nerve entrapment. Treatment of the nerve entrapment is similar to that for plantar fasciitis, with rest, activity modification, nonsteroidal antiinflammatory drugs, stretching exercise, and local steroid injection. Surgical release of the deep abductor hallucis fascia is indicated when conservative treatment failed. Endoscopic release of the nerve through the dorsal and plantar portals, as well as endoscopic plantar aponeurosis release, is a feasible approach. P lantar heel pain is one of the most common problems faced by orthopaedic surgeons. Differential diagnoses include plantar fasciitis, entrapment of the first branch of the lateral plantar nerve, fat pad disorders, stress fracture of the calcaneal body, fatigue fracture of the medial calcaneal tuberosity, rupture of the plantar aponeurosis, tarsal tunnel syndrome, sciatica, painful piezogenic heel papules, glomus tumor of the heel pad, and bone and soft tissue tumor. 1The most common cause of plantar heel pain is plantar fasciitis, which is usually cured with conservative care. Entrapment of the first branch of the lateral plantar nerve, which can occur together with plantar fasciitis, is one of the most commonly overlooked causes of plantar heel pain. The nerve consists of sensory fibers for the calcaneal periosteum and the long plantar ligament as well as motor fibers for the quadratus plantae, flexor digitorum brevis, and abductor digiti quinti muscles.2 Nerve entrapment syndrome has previously been considered only in cases with intractable heel pain, but it may play a role in the early phases of painful heel syndrome. 3Diagnosis of the nerve entrapment is made on clinical grounds. Early morning pain is uncommon with isolated nerve entrapment. It tends to cause more pain at the end of the day or after prolonged activity. This may be related to the engorgement of a vessel accompanying the first branch of the lateral plantar nerve causing ischemia of the nerve rather than pure static compression of the nerve by the fascia. 4 The pathognomonic sign is maximal tenderness at the medial border of the plantar heel where the nerve entrapment occurs.1 The diagnosis can be confirmed by injection of lidocaine and bupivacaine into the region of the nerve, resulting in complete, albeit temporary, relief of the pain.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoscopic Decompression of the First Branch of the Lateral Plantar Nerve and Release of the Plantar Aponeurosis for Chronic Heel Pain

Lui¹

2016

Arthroscopy Techniques

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“…Este ramo, casi siempre constante, se origina un poco antes de la división del nervio plantar lateral, se dirige anteriormente y cruza inferiormente al músculo abductor del dedo mínimo y, algunas veces, al músculo flexor corto del dedo mínimo, termina en el tejido subcutáneo, superficial al músculo. sistente efectuar la liberación de este primer ramo del nervio plantar lateral (Sadek et al, 2015). Por otra parte, según Rodrígues et al (2015), la atrofia grasa del músculo abductor del dedo mínimo está fuertemente asociada con aleraciones neuropáticas del ramo que inerva al músculo.…”

Section: Ramos Del Nervio Plantar Lateral Desde Su Origen Hasta Su DIunclassified

Primeros Ramos del Nervio Plantar Lateral: Revisión Anátomo - Clínica

Sol

Vásquez

2017

Int. J. Morphol.

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DEL SOL, M. & VÁSQUEZ, B.Primeros ramos del nervio plantar lateral. Revisión anátomo-clínica. Int. J. Morphol., 35(2):765-775, 2017. RESUMEN:El nervio plantar lateral es un ramo terminal del nervio tibial, inerva la mayor parte de la musculatura del pie, y otorga inervación sensitiva a parte de la planta del pie. En esta revisión abordamos diversos aspectos del nervio plantar lateral desde su origen hasta su división, dando énfasis a aquellos ramos que por su disposición anatómica han sido señalados como causantes de síndrome de compresión, y a variaciones anatómicas importantes que deben ser conocidas cuando se aborda la región plantar. Numerosos estudios se han realizado para describir el trayecto y relaciones de los primeros ramos del nervio plantar lateral. Los ramos emitidos directamente por el nervio plantar lateral están destinados a los músculos abductor del dedo mínimo y cuadrado plantar, además de un ramo cutáneo lateral y ramos vasculares para los vasos plantares laterales y para el ligamento plantar largo. Como variación anatómica es posible encontrar ramos calcáneos mediales, tronco común de ramos calcáneo medial y para el músculo abductor del dedo mínimo, 2 ó 3 ramos para el músculo cuadrado plantar, tronco común para los músculos abductor del dedo mínimo y cuadrado plantar, ramo para el músculo flexor corto del dedo mínimo y ramo "anastomótico" para el nervio plantar medial. Cada vez más, es más necesario tener conocimientos acabados de la anatomía del pie, particularmente en aquellos procedimientos quirúrgicos que requieren precisión, con abordajes menos radicales y buenos resultados.PALABRAS CLAVE: Nervio plantar lateral; Anatomía; Síndrome de compresión. INTRODUCCIÓNLa inervación del pie se realiza a través de ramos de los nervios fibular superficial, fibular profundo y tibial y, principalmente, sus ramos de división, los nervios plantares lateral y medial, quienes inervan el mayor territorio del pie, tanto muscular como cutáneo.Ramos originados del nervio plantar lateral, en especial los más proximales, han sido mencionados en las últi-mas décadas como eventuales causantes de dolor subcalcáneo, debido al síndrome de compresión de uno de ellos. A pesar que el síndrome del túnel tarsiano es menos frecuente que el síndrome del túnel carpiano, sus efectos pueden ser bastante graves debido a que comprometen la marcha y la posición de bipedestación, afectando seriamente la calidad de vida del paciente. Se sabe que gran parte de los ramos nerviosos que pueden ser afectados por compresión, son principalmente los ramos terminales del nervio tibial (ramos calcáneos mediales) o los primeros ramos del nervio plantar lateral (variación de origen de los ramos calcáneos mediales y ramo para el músculo abductor del dedo mínimo) quienes se ven especialmente comprometidos en la región calcánea y parte posterior de la planta del pie.Debido a lo anterior, numerosos estudios se han realizado para describir de manera precisa el trayecto y relaciones de estos primeros ramos del nervio plantar lateral. Existen estudi...

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“…Endoscopic plantar fasciotomy is also a reasonable option where conservative therapy has failed. In nerve entrapment, if conservative measures are ineffective after six to 12 months, surgical decompression should be considered [2][3][4]. And in recalcitrant cases, surgery to remove the Haglund deformity may be necessary [5].…”

Section: Introductionmentioning

confidence: 99%

Chosen Conservative Treatments on the Symptoms of Calcaneal Spur: A Short Review

Lizis¹

2018

Int J Foot Ankle

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Background: Calcaneal spur (CS) occurs when calcium deposits build up on the underside of the heel bone, a process that usually lasts for many months. CS often causes foot muscle strain, inflammation of the plantar fasciitis, repeated tearing of the membrane that covers the heel bone and pain. CS decreases physical activity, social capacity, reducing the quality of life, and becomes the cause of frequent absence from work due to sickness. It is a disease commonly appearing in adults, and it is also a serious social problem. Physiotherapy is an alternative method for pharmacology and surgery. It includes kinesiotherapy, orthoses, corticosteroid therapy, and electrotherapy, but their efficacy remains controversial. The aim of this manuscript was a short review of the effectiveness of therapeutic ultrasound (US) and extracorporeal shock wave therapy (ESWT) on the symptoms of CS.

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Lateral Plantar Nerve Release with or without Calcaneal Drilling for Resistant Plantar Fasciitis

Cited by 9 publications

References 29 publications

Endoscopic Decompression of the First Branch of the Lateral Plantar Nerve and Release of the Plantar Aponeurosis for Chronic Heel Pain

Endoscopic Decompression of the First Branch of the Lateral Plantar Nerve and Release of the Plantar Aponeurosis for Chronic Heel Pain

Primeros Ramos del Nervio Plantar Lateral: Revisión Anátomo - Clínica

Chosen Conservative Treatments on the Symptoms of Calcaneal Spur: A Short Review

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