Abstract
This is a case series study that was conducted to report the outcome of surgical release of the first branch of the lateral plantar nerve in patients with chronic heel pain. Thirty-one patients with chronic heel pain underwent release of the first branch of the lateral plantar nerve. The setting was a public university hospital and a public university-affiliated hospital in the north of Jordan. Six patients were lost to follow-up. The average age of the remaining 25 patients was 43.8 years. The average duration of symptoms prior to surgery was 15 months. Radiography showed spur in 14 cases. All patients had conservative treatment for a minimum of 6 months before surgery, and all had one or two local cortisone injection. The average length for recovery was 3 months. All patients, except for 2, reported fair to excellent results. Level of post-operative satisfaction between fair and excellent was reported by 75% at 3 months, 96% at 6 months and 80% at 3–11 years (average 8 years). The diagnosis of entrapment of the first branch of the lateral plantar nerve can be clinical and could be confirmed by nerve block. Heel spurs should be removed when in very close proximity relation to the first branch of the lateral plantar nerve.
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References
Bordelon RL (1993) Heel pain. In: Mann RA (ed) Surgery of the foot and ankle, ed.6.tlois. CV Mosby, pp 837–847
Goolsby MJ (2003) Diagnosis and treatment of heel pain. J Am Nurse Pract 15:485–486
Oztuna Z, Ozge A, Eskandari MM, Colak M, Goplpinar A, Kuyurtar F (2002) Nerve intrapment in painful heel syndrome. Foot Ankle Int 23:208–211
Tanz SS (1963) Heel pain. Clin Orthop 28:169–178
Rondhuis JJ, Huson A (1986) The first branch of the lateral plantar nerve and heel pain. Acta Morphol Neerl Scand 24:269–279
Baxter DE, Pfeffer GB (1992) Treatment of chronic heel pain by surgical release of the first branch of the lateral plantar nerve. Clin Orthop 279:229–236
Henrieson AS, Westlin NE (1984) Chronic calcaneal pain in athletes: entrapment of the calcaneal nerve? Am J Sports Med 12:152–154
Anderson RB, Foster MD (1989) Operative treatment of subcalcaneal heel pain. Foot Ankle 9:317–323
Schon LC, Glennon TP, Baxter DE (1993) Heel pain syndrome: electro-diagnostic support for nerve entrapment. Foot Ankle 14:129–135
Przylucki H, Jones CL (1981) Entrapment neuropathy of muscle branch of lateral planer nerve: a cause of heel pain. J Am Podiatry Assoc 71:119–124
Baxter DE, Pfeffer GB, Thighpen M (1989) Chronic heel pain treatment rational. Orthop Clin North Am 20:563–569
Baxter DE, Thighpen CM (1984) Heel pain—operative results. Foot Ankle 5:16–25
Lutter LD (1986) Surgical decisions in athletes’ subcalcaneal pain. Am J Sports Med 14:418–445
McCarthy DJ, Gorecki GE (1979) The anatomical basis of inferior calcaneal lesions: a cryomicrotomy study. J Am Podiatry Assoc 69:527–536
Gerster JC (1980) Plantar fasciitis and Achilles tendinitis among 150 cases of serosronegative spondarthritis. Rheumatol Rehabil 19:218–222
Gerster JC, Piccinin P (1985) Enthesopathy of the heels in juvenile onset seronegative B-27 positive spondyloarthropathy. J Rheumatol 12:310–314
Lichniak JE (1990) The heel in the systemic disease. Clin Podiatr Med Surg 7:225–241
Furey JG (1975) Plantar fasciitis. J Bone Joint Surg 57A:672–673
Eastmond CJ, Rajah SM, Tovey D et al (1980) Seronegative pauciarcular arthritis and HLA b27. Ann Rheum Dis 39:231–234
Graham CE (1983) Painful heel syndrome: rational of diagnosis and treatment. Foot Ankle 3:261–267
Wearing SC, Smeathers JE, Urry SR, Hening EM, Hills AP (2006) The pathomechanics of plantar fasciitis. Sport Med 36:585–611
Jolly GP, Zgonis T, Hendrix CL (2005) Neurogenic heel pain. Clin Podiatr Med Surg 22:101–113
May TJ, Judy TA, Conti M, Cpwan JE (2002) Current treatment of plantar fasciitis. Curr Sport Med Rep 1:278–284
Magda P, Latov N, Renard MV, Sander HW (2002) Quantitative sensory testing: high sensitivity in small fiber neuropathy with normal NCS/EMG. J Peripher Nerv Syst 7:225–228
Crawford F, Thomson C (2003) Interventions for treating plantar heel pain. Cochrane data base of systemic reviews (online) 2003(3) CD000416
Kenzora JE (1987) The painful heel syndrome: an entrapment neuropathy. Bull Hosp Jt Dis Orthop Inst 47:178–189
Sammarco GJ, Helfrey RB (1996) Surgical treatment of recal-citrnt plantar fasciitis. Foot Ankle 17:520
Hendrix CL, Jolly GP, Garbalosa JC, Blume P, DosRemedios E (1998) Entrapment neuropathy: the etiology of intractable chronic heel pain syndrome. J Foot Ankle Surg 37:273–279
Forman WM, Green MA (1990) The role of intrinsic musculature in the formation of inferior calcaneal exostosis. Clin Podiatr Med Surg 7:217–222
Lapidus PW, Guidotti FP (1965) Painful heel: report of 323 patients with 364 painful heels. Clin Orthop 39:179–186
Rubin G, Witten M (1963) Plantar calcaneal spurs. AMJ Orthop 5:38–55
Schepsis AA, Leach RE, Gorzycz J (1991) plantar fasciitis, etiology, treatment, surgical results and review of the literature. Clin Orthop 266:185–196
Gray H, Standring SM, Ellis H, Berkovitz BKB (2005) Grays anatomy: the anatomical basis of clinical practice, 39th edn. Elsevier churchil livigstone, Edinburgh
Arenson DJ, Cosentino GL, Suran SM (1980) The inferior calcaneal nerve; an anatomical study. J Am Podiatry Assoc 70:552–560
Louisia S, Masquelet AC (1999) The medial and inferior calcaneal nerves: an anatomic study. Surg Radiol Anat 21:169–173
Lui TH (2007) Endoscopic decompression of the first branch of the lateral planter nerve. Arch Orthop Trauma Surg 127:859–861
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Mesmar, M., Amarin, Z., Shatnawi, N. et al. Chronic heel pain due to the entrapment of the first branch of the lateral plantar nerve: analysis of surgical treatment. Eur J Orthop Surg Traumatol 20, 563–567 (2010). https://doi.org/10.1007/s00590-010-0609-5
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DOI: https://doi.org/10.1007/s00590-010-0609-5