• 1.

    Barrett SJ & O'Malley R: Plantar fasciitis and other causes of heel pain. Am Fam Physician 59 : 2200, 1999.

  • 2.

    Barrett SL: Practical Pain Management for the Lower Extremity Surgeon, 1st Ed, Data Trace, Brooklandville, MD, 2015.

  • 3.

    Park SY, Bang HS & Park DJ: Potential for foot dysfunction and plantar fasciitis according to the shape of the foot arch in young adults. J Exerc Rehabil 14 : 497, 2018.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 4.

    Mackinnon SE & Dellon AL: Surgery of the Peripheral Nerve, Thieme, New York, 1988.

  • 5.

    Melendez MM, Patel A & Dellon AL: The diagnosis and treatment of Joplin's neuroma. J Foot Ankle Surg 55 : 320, 2016.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 6.

    Ferner H & Monsen, H: Eduard Pernkopf's Atlas of Topographical and Applied Human Anatomy, Vol, 2, Urban and Schwarzkopf, Baltimore, 1964.

  • 7.

    Rochen JW, Yokochi C & Lütjen-Drescoll E: A Photographic Study of the Human Body, Philadelphia, Lippincott Williams & Williams, 2006.

  • 8.

    Blacklidge DK, Kurek JB & Soto AD et al.: Acute exertional compartment syndrome of the medial foot. J Foot Ankle Surg 35 : 19, 1996.

  • 9.

    Izadi FE & Richie DH Jr: Exertional compartment syndrome of the medial foot compartment—diagnosis and treatment: a case report. JAPMA 104 : 417, 2014.

    • Search Google Scholar
    • Export Citation
  • 10.

    Dellon AL & Fine IT: A noninvasive technique for diagnosis of chronic compartment syndrome in the first dorsal interosseous muscle. J Hand Surg Am 15 : 1008, 1990.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Williams EH, Williams CG & Rosson GD et al.: Anatomic site for proximal tibial nerve compression: a cadaver study. Ann Plast Surg 62 : 322, 2009.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation

Midarch Foot Pain: Entrapment Neuropathy of the Distal Medial Plantar Nerve and Its Branches

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Medial forefoot pain, or midarch pain, is usually attributed to plantar fasciitis. The authors present their findings of a previously unreported nerve entrapment of the medial proper plantar digital nerve (MPPDN). Ten fresh-frozen cadaveric specimens were analyzed for anatomical variance in the nerve distribution of the MPPDN. In addition, clinical results from a retrospective review of nine patients who underwent surgical nerve decompression of the MPPDN are presented. Significant anatomical variance was found for the MPPDN in the cadaveric dissection of 10 fresh-frozen specimens. Nine patients with a clinical diagnosis of entrapment of the MPPDN all obtained excellent pain relief with surgical external neurolysis. Only one complication occurred: a hypertrophic scar formation that was successfully treated with intralesional steroid injections. The authors believe that this MPPDN entrapment is often overlooked or misdiagnosed as plantar fasciitis. Surgical peripheral nerve decompression of this nerve can provide positive outcomes for patients suffering from midarch foot pain caused by this pain generator.

US Neuropathy Centers, Atlanta, GA.

University of Georgia, Athens, GA.

Johns Hopkins University, Baltimore, MD.

Corresponding author: Stephen L. Barrett, DPM, US Neuropathy Centers, 2550 Windy Hill Road, Ste 206 Marietta, GA 30067. (E-mail: sbarrett@usnerve.com)