Summary
The existence of chronic heel pain induced by the compression of nerves prompted us to conduct an anatomic study of the innervation of the heel. Fifteen cadaver feet were dissected to investigate the origin, course and branches of the medial calcaneal nerve (MCN) and the inferior calcaneal nerve (ICN). Despite a variable origin (tibial n. (TN) or lateral plantar n. (LPN), the medial calcaneal nerve branches which lay superficial to the abductor hallucis muscle (AH) were quite constant. The medial calcaneal nerve gave branches to the abductor hallucis muscle and innervated the posterior part of the medial face of the heel. It terminated in the superficial heel pad at the inferior part of the heel. In our study, the inferior calcaneal nerve always originated from the lateral plantar nerve. Its relationship to the deep fascia of the abductor hallucis muscle and anterior tubercle of calcaneus may explain the entrapment syndrome of the inferior calcaneal nerve.
Résumé
L'existence de talalgies chroniques liées à des compressions nerveuses a motivé cette étude de l'innervation du talon. Quinze pieds de cadavres ont été disséqués pour explorer l'origine, le trajet, et les collatérales des nerfs calcanéen médial (NCM) et calcanéen inférieur (NCI). L'origine du NCM était variable : nerf tibial postérieur ou nerf plantaire latéral, la distribution de ses branches, superficielles par rapport au muscle abducteur de l'hallux, étant relativement constante. Elles étaient destinées au muscle abducteur de l'hallux et à la partie postérieure de la face médiale du talon. La portion terminale du nerf calcanéen médial s'épuisait dans le coussin adipeux superficiel du talon à la face inférieure du calcanéus. Le nerf calcanéen inférieur naissait toujours du nerf plantaire latéral. Ses rapports avec le fascia profond du muscle abducteur de l'hallux et le tubercule antérieur du calcanéus accréditent la possibilité d'un syndrome canalaire.
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References
Arenson DJ, Cosentino GL, Suran SM (1980) The inferior calcaneal nerve: an anatomic study. J Am Podiatr Ass 70: 552–560
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
Davis TJ, Schon LC (1995) Branches of the tibial nerve: anatomic variations. Foot Ankle Int 16: 21–29
Dellon AL, Mackinnon SE (1984) Tibial nerve branching in the tarsal tunnel. Arch Neurol, 41: 645–646
Didia BC, Horsefall AU (1990) Medial calcaneal nerve: an anatomic study. J Am Podiatr Ass 80: 115–119
Gray H (1989) Gray's Anatomy.37th edition, Churchill Livingstone
Hamm JT, Sanders M (1987) Anatomic variations of the nerve to the abductor digiti quinti muscle. Foot Ankle 8: 123
Havel PE, Ebraheim NA, Clark SE, Jackson WT, Didio L (1988) Tibial nerve branching in the tarsal tunnel. Foot Ankle 9: 117–119
Henricson AS, Westlin NE (1984) Chronic calcancal pain in athletes: entrapment of the calcaneal nerve? Am J Sports Med 12: 152–154
Horwitz MT (1938) Normal anatomy and variations of the peripheral nerves of the leg and foot. Arch Surg 36: 626–636
Kenzora JE (1987) The painful heel syndrome: an entrapment neuropathy. Bull Hosp Jt Dis Ortho Inst 47: 178–89
Kopell HP, Thompson AL (1960) Peripheral entrapment neuropathies of the lower extremity. N Engl J Med 262: 56–60
Mabin D (1997) Compressions nerveuses distales du membre inférieur. Etude clinique et électrophysiologique. Neurophysiol Clin 27: 9–24
Mestdagh H, Houcke M, Moulront S, Laraki A (1980) Contribution à l'étude de l'innervation sensitive de la coque talonnière. Acta anat 108: 124–131
Park TA, Del Toro DR (1995) The medial calcaneal nerve: anatomy and nerve conduction technique. Muscle and Nerve 18: 32–38
Park TA, Del Toro DR (1996) Isolated inferior calcaneal neuropathy. Muscle and Nerve 19: 106–108
Przylucki H, Jones CL (1981) Entrapment neuropathy of muscle branch of lateral plantar nerve. J Am Podiatry Assoc 71: 119–124
Roegholt MN (1940) Een nervus calcaneus inferior als overbrenger, Van de pijn bij calcaneodynie of calcaneuss poor en de daaruit volgen therapie. Ned Tijdschr Geneeskd 84: 1898–1902
Rondhuis JJ, Huson A (1986) The first branch of the lateral plantar nerve and heel pain. Acta Morphol Neerl Scand 24: 269–279
Rouviere H, Delmas A (1984) Anatomie Humaine Tome III. 12ème edition, Masson, Paris
Santi MD, Botte MJ (1996) External fixation of the calcaneus and talus: an anatomic study for safe pin insertion. J Orthop Trauma 10: 487–491
Schon LC, Glennon TP, Baxter DE (1993) Heel pain syndrome: electrodiagnostic support for nerve entrapment. Foot Ankle 14: 129–35
Schon LC, Baxter DE (1990) Neuropathies of the foot and ankle in athletes. Clin Sports Med 9: 489–509
Tanz SS (1963) Heel pain. Clin Orthop 28: 169–177
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Louisia, S., Masquelet, A.C. The medial and inferior calcaneal nerves: an anatomic study. Surg Radiol Anat 21, 169–173 (1999). https://doi.org/10.1007/BF01630895
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DOI: https://doi.org/10.1007/BF01630895