Clinical-anatomic mapping of the tarsal tunnel with regard to Baxter’s neuropathy in recalcitrant heel pain syndrome: part I

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Abstract

Purpose

Neuropathy of the Baxter nerve (BN) seems to be the first cause of the heel pain syndrome (HPS) of neurological origin.

Methods

41 alcohol–glycerol embalmed feet were dissected. We documented the pattern of the branches of the tibial nerve (TN) and describe all relevant osteofibrous structures. Measurements for the TN branches were related to the Dellon–McKinnon malleolar-calcaneal line also called DM line (DML) for the proximal TT and the Heimkes Triangle for the distal TT. Additionally, we performed an ultrasound-guided injection procedure of the BN and provide an algorithm for clinical usage.

Results

The division of the TN was 16.4 mm proximal to the DML. The BN branches off 20 mm above the DML center or 30 mm distally to it. In most of the cases, the medial calcaneal branch (MCB) originated from the TN proximal to the bifurcation. Possible entrapment spots for the medial and lateral plantar nerve (MPN, LPN), the BN and the MCB are found within a circle of 5 mm radius with a probability of 80%, 83%, and 84%, respectively. In ten out of ten feet, the US-guided injection was precisely allocated around the BN.

Conclusions

Our detailed mapping of the TN branches and their osteofibrous tubes at the TT might be of importance for foot and ankle surgeons during minimally invasive procedures in HPS such as ultrasound-guided ankle and foot decompression surgery (UGAFDS).

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Most cited references 38

Record: found
Abstract: found
Article: not found

The population prevalence of foot and ankle pain in middle and old age: a systematic review.

Martin Thomas, Edward Roddy, Weiya Zhang … (2011)

A systematic review and meta-analysis of population-based epidemiological studies was undertaken to determine the prevalence of foot and ankle pain in middle and old age. Searches were conducted in the following electronic databases from inception to October 2010: PubMed, EMBASE, AMED, CINAHL, Cochrane, PEDro, and SportDiscus. Full-text English language articles were included if they used population sample frames, cross-sectional design or analysis, and reported prevalence estimates for foot and/or ankle pain in adults aged 45 years and over. Thirty-four articles from 31 studies involving 75,505 participants provided 529 prevalence estimates based on different case definitions and population strata. Random-effects meta-analyses of studies with comparable case definitions provided pooled prevalence estimates, for frequent foot pain of 24% (95% confidence interval 22-25%; n=3; I(2)=46%) and for frequent ankle pain of 15% (95% confidence interval 13-16%; n=2; I(2)=0). Small sample sizes and low response rates in some studies, together with heterogeneous case definitions, limit confident conclusions on the distribution, subtypes, and impact of foot/ankle pain. Narrative synthesis of evidence from existing studies suggested preponderance in females, an age-related increase in prevalence in women but not men, that the toes/forefoot were the most common anatomical sites of pain, and that moderate disability in an aspect of daily life was reported by two-thirds of cases. This review provides estimates of the community burden of foot and ankle pain in middle and old age. By outlining the scale of this clinical problem, these findings can be used to inform health care planning and provision. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

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Record: found
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Article: not found

High-resolution ultrasonography of the carpal tunnel.

W Jungwirth, W Buchberger, G Schön … (1991)

Twenty-eight wrists of 25 patients with carpal tunnel syndrome (CTS) and 28 wrists of 14 normal control subjects were studied with high-frequency real-time ultrasonography. Three general findings could be observed in CTS, regardless of its cause: swelling of the median nerve at the entrance of the carpal tunnel; flattening of the median nerve in the distal carpal tunnel; and increased palmar flexion of the transverse carpal ligament. Quantitative analysis proved these findings to be significant. We conclude that high-resolution sonography is able to diagnose median nerve compression in the carpal tunnel syndrome and to detect some of its potential causes.

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US of nerve entrapments in osteofibrous tunnels of the upper and lower limbs.

Lisa Del Valle-Mojica, L Derchi, C Martinoli … (2000)

The diagnosis of nerve entrapment at osteofibrous tunnels relies primarily on clinical and electrodiagnostic findings. Recently, the refinement of high-frequency broadband transducers with a range of 5-15 MHz, sophisticated focusing in the near field, and sensitive color and power Doppler technology have improved the ability to evaluate peripheral nerve entrapment in osteofibrous tunnels with ultrasonography (US). In the upper limb, osteofibrous tunnels amenable to US examination include the carpal tunnel for the median nerve and the cubital and Guyon tunnels for the ulnar nerve. In the lower limb, these tunnels include the fibular neck for the common peroneal nerve, the tarsal tunnel for the posterior tibial nerve, and the intermetatarsal spaces for the interdigital nerves. High-resolution US allows direct imaging of the involved nerves, as well as documentation of changes in nerve shape and echotexture that occur in compressive syndromes. A spectrum of extrinsic causes of entrapment, such as tenosynovitis, ganglia, soft-tissue tumors, bone and joint abnormalities, and anomalous muscles, can also be diagnosed with US. With continued experience, it is likely that this technique will be increasingly used to evaluate nerve entrapment syndromes.

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Author and article information

Contributors

Marko Konschake:

ORCID: http://orcid.org/0000-0002-9706-7396

+43-512-9003-71130 , marko.konschake@i-med.ac.at

Journal

Journal ID (nlm-ta): Surg Radiol Anat

Journal ID (iso-abbrev): Surg Radiol Anat

Title: Surgical and Radiologic Anatomy

Publisher: Springer Paris (Paris )

ISSN (Print): 0930-1038

ISSN (Electronic): 1279-8517

Publication date (Electronic): 27 October 2018

Publication date PMC-release: 27 October 2018

Publication date (Print): 2019

Volume: 41

Issue: 1

Pages: 29-41

Affiliations

[1 ]Minimally invasive Foot and Ankle Surgery, Faculty of Physical Therapy and Podiatry, Catholic University Saint Vincent Martyr, Valencia, Spain

[2 ]Faculty of Health Sciences at Manresa, Universitat de Vic-Universitat Central de Catalunya (Uvic-Ucc), Barcelona, Spain

[3 ]ISNI 0000 0000 8853 2677, GRID grid.5361.1, Department of Plastic, Reconstructive and Aesthetic Surgery, Center of Operative Medicine, , Medical University of Innsbruck, ; Innsbruck, Austria

[4 ]ISNI 0000 0000 8853 2677, GRID grid.5361.1, Department of Anatomy, Histology and Embryology, Division of Clinical and Functional Anatomy, , Medical University of Innsbruck, ; Müllerstr. 59, 6020 Innsbruck, Austria

[5 ]Faculty of Health Sciences Manresa, Universitat de Vic-Universitat Central de Catalunya (Uvic-Ucc), Barcelona, Spain

Author information

Marko Konschake http://orcid.org/0000-0002-9706-7396

Article

Publisher ID: 2124

DOI: 10.1007/s00276-018-2124-z

PMC ID: 6514163

PubMed ID: 30368565

SO-VID: b3d6fc61-3728-487a-aa3a-f98dd1688827

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Date received : 17 September 2018

Date accepted : 21 October 2018

Custom metadata

ScienceOpen disciplines: Surgery

Keywords: baxter’s nerve,ultrasound,heel pain syndrome,tarsal tunnel

Data availability:

ScienceOpen disciplines: Surgery

Keywords: baxter’s nerve, ultrasound, heel pain syndrome, tarsal tunnel

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Clinical-anatomic mapping of the tarsal tunnel with regard to Baxter’s neuropathy in recalcitrant heel pain syndrome: part I

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Most cited references 38

The population prevalence of foot and ankle pain in middle and old age: a systematic review.

High-resolution ultrasonography of the carpal tunnel.

US of nerve entrapments in osteofibrous tunnels of the upper and lower limbs.

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