• 1

    Bonica JJ, Loeser JD: “Applied Anatomy Relevant to Pain,” in Bonica’s Management of Pain, ed by JD Loeser, SH Butler, CR Chapman, et al, p 196, Lippincott Williams & Wilkins, Philadelphia. ,2001. .

    • PubMed
    • Export Citation
  • 2

    Ivanusic JJ: The evidence for the spinal segmental innervation of bone. .Clin Anat 20::956. ,2007. .

  • 3

    Coda BA, Bonica JJ: “General Considerations of Acute Pain,” in Bonica’s Management of Pain, 3rd Ed, ed by JD Loeser, SH Butler, CR Chapman, et al, p 222, Lippincott Williams & Wilkins, Philadelphia. ,2001. .

    • PubMed
    • Export Citation
  • 4

    Meyr AJ, Steinberg JS: The physiology of the acute pain pathway. .Clin Podiatr Med Surg 25::305. ,2008. .

  • 5

    Hallivis R, Derksen TA, Meyr AJ: Peri-operative pain management. .Clin Podiatr Med Surg 25::443. ,2008. .

  • 6

    Meyr AJ, Steinberg JS: Clinical pain management peri-operative scenarios. .Clin Podiatr Med Surg 25::517. ,2008. .

  • 7

    Dejerine J: Sémiologie du Système Nerveux, p 575, Masson, Paris. ,1914. .

    • PubMed
    • Export Citation
  • 8

    Kellgren JH: Observations on referred pain arising from muscle. .Clin Sci 3::175. ,1937. .

  • 9

    Kellgren JH: On the distribution of pain arising from deep somatic structures with charts of segmental pain areas. .Clin Sci 4::35. ,1939. .

  • 10

    Lewis T, Kellgren JH: Observations relating to referred pain, visceromotor reflexes and other associated phenomena. .Clin Sci 4::47. ,1939. .

  • 11

    Kellgren JH: Deep pain sensibility. .Lancet 1::943. ,1949. .

  • 12

    Inman VT, Saunders JB: Referred pain from skeletal structures. .J Nerv Ment Dis 99::660. ,1944. .

  • 13

    Inman VT, Saunders JB: Anatomicophysiological aspects of injuries to the intervertebral disc. .J Bone Joint Surg Am 29::461. ,1947. .

  • 14

    Bonica JJ, Cailliet R, Loeser JD: “General Considerations of Pain in the Neck and Upper Limb,” in Bonica’s Management of Pain, ed by JD Loeser, SH Butler, CR Chapman, et al, p 983, Lippincott Williams & Wilkins, Philadelphia. ,2001. .

    • PubMed
    • Export Citation
  • 15

    Sarrafian SK: “Nerves,” in Anatomy of the Foot and Ankle, ed by SK Sarrafian, p 313, JB Lippincott Co, Philadelphia. ,1983. .

    • PubMed
    • Export Citation
  • 16

    Williams PL, Bannister LH, Berry MM, et al, eds: Gray’s Anatomy: The Anatomical Basis of Medicine and Surgery, Churchhill Livingstone, New York. ,1995. .

    • PubMed
    • Export Citation
  • 17

    Seely RR, Stephens TD, Tate P: Anatomy and Physiology, 8th Ed, McGraw-Hill, Boston. ,2008. .

    • PubMed
    • Export Citation
  • 18

    Horwitz MT: Normal anatomy and variations of the peripheral nerves of the leg and foot. .Arch Surg 36::626. ,1938. .

  • 19

    Gardner E, Gray DJ: The innervation of the joints of the foot. .Anat Rec 161::141. ,1968. .

  • 20

    Lippert H: Zur innervation der menshlichen fugelenke. .Z Anat Entwgesh 123::295. ,1962. .

  • 21

    Cavaliere RG, Pappas E: “Anesthesia,” in McGlamry’s Comprehensive Textbook of Foot and Ankle Surgery, 3rd Ed, ed by AS Banks, MS Downey, DE Martin, et al, p 177, Lippincott Williams & Wilkins, Philadelphia. ,2001. .

    • PubMed
    • Export Citation
  • 22

    Worrell JB, Barbour G: The Mayo block: an efficacious block for hallux and first metatarsal surgery. .AANA J 64::146. ,1996. .

  • 23

    Singelyn FJ: Single-injection applications for foot and ankle surgery. .Best Pract Res Clin Anaesthesiol 16::247. ,2002. .

Lower-Extremity Sclerotomes

Clinical Applications and the Modified Mayo Block

Andrew J. Meyr Department of Orthopedics, INOVA Fairfax Hospital, Falls Church, VA.

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Raymond DiPrimio Department of Anatomy, Temple University School of Podiatric Medicine, Philadelphia, PA.

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A sclerotome is an anatomical concept that defines an area of bone supplied by a single spinal nerve. Similar to the familiar dermatomes, sclerotomes provide an element of depth to the sensory innervation of the lower extremity based on the deep fascia as an embryologic boundary. Anatomical knowledge of sclerotomes can be used clinically in the diagnosis and treatment of pain and in the perioperative setting. Specifically, a modified version of the classic Mayo block is presented to highlight an active anatomical approach to peripheral nerve blockade. (J Am Podiatr Med Assoc 99(3): 232–235, 2009)

Corresponding author: Andrew J. Meyr, DPM, Department of Orthopedics, INOVA Fairfax Hospital, Podiatric Surgery Residency Office, 3300 Gallows Rd, Falls Church, VA 22042. (E-mail: ajmeyr@gmail.com)
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