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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia Del Piede 2003 September;27(3):115-20
Entrapment syndrome of lateral plantar nerve: a case report
De Pasquali P.
Described for the first time by Valtin in 1992, the lateral plantar nerve syndrome is an entrapment syndrome caused by the compression of this nerve after its origin from the posterior tibialis nerve. A particular clinical sign is the pain located on the lateral side of the sole to the lesser toes; heel pain, metatarsalgia and loss of strength in the abductor digiti minimi muscle may exist. The EMG often shows a lesion of the lateral plantar nerve (LPN) and injury of the adbuctor digiti minimi muscle. The authors describe a case of LPN syndrome in a 53 year-old woman, suffering from plantar and heel pain, and metatarsalgia too for more than 8 years. Symptomatology and EMG permitted diagnosis. At the operation of the 1st foot, the entrapment was due to perineural adhesion and varicose veins of the posterior tibialis plexus; in the 2nd foot it was due to compression of the nerve by the flexor digitorum brevis muscle aponeurosis. A bilateral neurectomy of II digital nerve for contemporaneous Morton disease was associated. Neurolysis operations for LPN initially gave a remarkable improvement, followed by partial reappearance of the pain, probably due to perineural scar. The authors describe the anatomy of the region and the differential diagnosis.