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Chronic heel pain due to the entrapment of the first branch of the lateral plantar nerve: analysis of surgical treatment

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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

  1. Bordelon RL (1993) Heel pain. In: Mann RA (ed) Surgery of the foot and ankle, ed.6.tlois. CV Mosby, pp 837–847

  2. Goolsby MJ (2003) Diagnosis and treatment of heel pain. J Am Nurse Pract 15:485–486

    Article  Google Scholar 

  3. 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

    PubMed  Google Scholar 

  4. Tanz SS (1963) Heel pain. Clin Orthop 28:169–178

    CAS  PubMed  Google Scholar 

  5. Rondhuis JJ, Huson A (1986) The first branch of the lateral plantar nerve and heel pain. Acta Morphol Neerl Scand 24:269–279

    CAS  PubMed  Google Scholar 

  6. 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

    PubMed  Google Scholar 

  7. Henrieson AS, Westlin NE (1984) Chronic calcaneal pain in athletes: entrapment of the calcaneal nerve? Am J Sports Med 12:152–154

    Article  Google Scholar 

  8. Anderson RB, Foster MD (1989) Operative treatment of subcalcaneal heel pain. Foot Ankle 9:317–323

    CAS  PubMed  Google Scholar 

  9. Schon LC, Glennon TP, Baxter DE (1993) Heel pain syndrome: electro-diagnostic support for nerve entrapment. Foot Ankle 14:129–135

    CAS  PubMed  Google Scholar 

  10. 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

    CAS  PubMed  Google Scholar 

  11. Baxter DE, Pfeffer GB, Thighpen M (1989) Chronic heel pain treatment rational. Orthop Clin North Am 20:563–569

    CAS  PubMed  Google Scholar 

  12. Baxter DE, Thighpen CM (1984) Heel pain—operative results. Foot Ankle 5:16–25

    CAS  PubMed  Google Scholar 

  13. Lutter LD (1986) Surgical decisions in athletes’ subcalcaneal pain. Am J Sports Med 14:418–445

    Article  Google Scholar 

  14. McCarthy DJ, Gorecki GE (1979) The anatomical basis of inferior calcaneal lesions: a cryomicrotomy study. J Am Podiatry Assoc 69:527–536

    CAS  PubMed  Google Scholar 

  15. Gerster JC (1980) Plantar fasciitis and Achilles tendinitis among 150 cases of serosronegative spondarthritis. Rheumatol Rehabil 19:218–222

    Article  CAS  PubMed  Google Scholar 

  16. Gerster JC, Piccinin P (1985) Enthesopathy of the heels in juvenile onset seronegative B-27 positive spondyloarthropathy. J Rheumatol 12:310–314

    CAS  PubMed  Google Scholar 

  17. Lichniak JE (1990) The heel in the systemic disease. Clin Podiatr Med Surg 7:225–241

    CAS  PubMed  Google Scholar 

  18. Furey JG (1975) Plantar fasciitis. J Bone Joint Surg 57A:672–673

    Google Scholar 

  19. Eastmond CJ, Rajah SM, Tovey D et al (1980) Seronegative pauciarcular arthritis and HLA b27. Ann Rheum Dis 39:231–234

    Article  CAS  PubMed  Google Scholar 

  20. Graham CE (1983) Painful heel syndrome: rational of diagnosis and treatment. Foot Ankle 3:261–267

    CAS  PubMed  Google Scholar 

  21. Wearing SC, Smeathers JE, Urry SR, Hening EM, Hills AP (2006) The pathomechanics of plantar fasciitis. Sport Med 36:585–611

    Article  Google Scholar 

  22. Jolly GP, Zgonis T, Hendrix CL (2005) Neurogenic heel pain. Clin Podiatr Med Surg 22:101–113

    Article  PubMed  Google Scholar 

  23. May TJ, Judy TA, Conti M, Cpwan JE (2002) Current treatment of plantar fasciitis. Curr Sport Med Rep 1:278–284

    Google Scholar 

  24. 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

    Article  PubMed  Google Scholar 

  25. Crawford F, Thomson C (2003) Interventions for treating plantar heel pain. Cochrane data base of systemic reviews (online) 2003(3) CD000416

  26. Kenzora JE (1987) The painful heel syndrome: an entrapment neuropathy. Bull Hosp Jt Dis Orthop Inst 47:178–189

    CAS  PubMed  Google Scholar 

  27. Sammarco GJ, Helfrey RB (1996) Surgical treatment of recal-citrnt plantar fasciitis. Foot Ankle 17:520

    CAS  PubMed  Google Scholar 

  28. 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

    Article  CAS  PubMed  Google Scholar 

  29. Forman WM, Green MA (1990) The role of intrinsic musculature in the formation of inferior calcaneal exostosis. Clin Podiatr Med Surg 7:217–222

    CAS  PubMed  Google Scholar 

  30. Lapidus PW, Guidotti FP (1965) Painful heel: report of 323 patients with 364 painful heels. Clin Orthop 39:179–186

    Google Scholar 

  31. Rubin G, Witten M (1963) Plantar calcaneal spurs. AMJ Orthop 5:38–55

    CAS  Google Scholar 

  32. Schepsis AA, Leach RE, Gorzycz J (1991) plantar fasciitis, etiology, treatment, surgical results and review of the literature. Clin Orthop 266:185–196

    PubMed  Google Scholar 

  33. Gray H, Standring SM, Ellis H, Berkovitz BKB (2005) Grays anatomy: the anatomical basis of clinical practice, 39th edn. Elsevier churchil livigstone, Edinburgh

    Google Scholar 

  34. Arenson DJ, Cosentino GL, Suran SM (1980) The inferior calcaneal nerve; an anatomical study. J Am Podiatry Assoc 70:552–560

    CAS  PubMed  Google Scholar 

  35. Louisia S, Masquelet AC (1999) The medial and inferior calcaneal nerves: an anatomic study. Surg Radiol Anat 21:169–173

    Article  CAS  PubMed  Google Scholar 

  36. Lui TH (2007) Endoscopic decompression of the first branch of the lateral planter nerve. Arch Orthop Trauma Surg 127:859–861

    Article  PubMed  Google Scholar 

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Correspondence to Zouhair Amarin.

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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

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