• 1. 

    Kim J & Dellon AL: Pain at the site of tarsal tunnel incision due to neuroma of the posterior branch of the saphenous nerve. JAPMA 91: 109, 2001.

  • 2. 

    Blacklidge DK , Masadeh SB & Lyons MC II, et al.: A preliminary review of the use of deep peroneal neurectomy for the treatment of painful midtarsal and tarsometatarsal arthritis. J Foot Ankle Surg 51: 464, 2012.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 3. 

    Dellon AL & Barrett SL: Sinus tarsi denervation: clinical results. JAPMA 95: 108, 2005.

  • 4. 

    Dellon AL: Partial joint denervation II: knee and ankle. Plast Reconstr Surg 123: 208, 2009.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 5. 

    Dellon A , Andonian E & Rosson GD: CRPS of the upper or lower extremity: surgical treatment outcomes. J Brachial Plex Peripher Nerve Inj 4: 1, 2009.

  • 6. 

    Harris JD , Fazalare JJ & Griesser MJ et al.: Infrapatellar branch of saphenous neurectomy for painful neuroma: a case report. Am J Orthop 41: 37, 2012.

  • 7. 

    Dellon AL: Joint Denervation: An Atlas of Surgical Techniques, Springer, New York, 2019.

  • 8. 

    Pyne D , Jawad ASM & Padhiar N: Saphenous nerve injury after fasciotomy for compartment syndrome. Br J Sports Med 37: 541, 2003.

  • 9. 

    Lugo-Pico JG , Aiyer A & Kaplan J et al.: “Foot Compartment Syndrome Controversy,” in Compartment Syndrome: A Guide to Diagnosis and Management, p 97, Springer, Cham, Switzerland, 2019.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10. 

    Frink M , Hildebrand F & Krettek C et al.: Compartment syndrome of the lower leg and foot. Clin Orthop Relat Res 468: 940, 2010.

  • 11. 

    Fulkerson E , Razi A & Tejwani N: Acute compartment syndrome of the foot. Foot Ankle Int 24: 180, 2003.

  • 12. 

    Pyne D , Jawad AS & Padhiar N: Saphenous nerve injury after fasciotomy for compartment syndrome. Br J Sports Med 37: 541, 2003.

  • 13. 

    Marsland D , Dray A & Little NJ et al.: The saphenous nerve in foot and ankle surgery: its variable anatomy and relevance. Foot Ankle Surg 19: 76, 2013.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 14. 

    Eglitis N , Horn JL & Benninger B et al.: The importance of the saphenous nerve in ankle surgery. Anesth Analg 122: 1704, 2016.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 15. 

    Vwaire O , Urits I & Orman S et al.: A systematic review of radiofrequency treatment of the ankle for the management of chronic foot and ankle pain. Current Pain Headache Rep 23: 4, 2019.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 16. 

    Eberlin KR & Ducic I: Surgical algorithm for neuroma management: a changing treatment paradigm. Plast Reconstr Surg Glob Open 6: e1952, 2018.

  • 17. 

    Morrison C & Dalsing MC: Signs and symptoms of saphenous nerve injury after greater saphenous vein stripping: prevalence, severity, and relevance for modern practice. J Vasc Surg 38: 886, 2003.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18. 

    Martín TB , Durán EI & Campos MSM: Complications after ankle and hindfoot arthroscopy. Rev Esp Cir Ortop Traumatol 60: 387, 2016.

  • 19. 

    Brown MN , Pearce BS & Karl HW et al.: “Distal Saphenous Nerve Entrapment,” in Peripheral Nerve Entrapments: Clinical Diagnosis and Management, p 645, Springer, Cham, Switzerland, 2016.

    • PubMed
    • Search Google Scholar
    • Export Citation

Saphenous Nerve Denervation for Chronic Pain After Compartment Syndrome of the Foot

A Case Report

Michael S. Nirenberg
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Elizabeth A. Ansert
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Denervation has been a recommended treatment option for a range of pathologies, including relief from chronic pain; however, literature discussing complete denervation of the distal saphenous nerve for foot pain has not been found. A case report of surgical decompression for compartment syndrome resulting in chronic, debilitating foot pain that was successfully alleviated by complete saphenous nerve denervation is presented. The predominant area of the patient's pain was on the medial aspect of the foot, where a thickened scar from a decompression fasciotomy was noted. The patient's initial pain score was reported as 10 of 10, with no relief from numerous conservative treatments attempted over an 11-year period. After a diagnostic injection of a local anesthetic to the distal saphenous nerve provided the patient with immediate, temporary relief, complete denervation of the distal saphenous nerve was performed. The patient reported significant pain reduction shortly after the procedure. This case suggests that physicians should be cognizant of the saphenous nerve and its branches, as well as its variable pathways during surgery. In addition, practitioners should be aware of its influence as a progenitor of pain in the foot that may require denervation.

Friendly Foot Care PC, Crown Point, IN.

Barry University, Miami, FL. Dr. Ansert is now with St. Vincent Hospital, Worcester, MA.

Corresponding author: Michael S. Nirenberg, DPM, Friendly Foot Care PC, 50 W 94th Pl, Crown Point, IN 46307. (E-mail: info@friendlyfootcare.com)

Conflict of Interest: None reported.

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