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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE

A Journal on Physiopathology and Surgery of the Foot


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Chirurgia Del Piede 2007 August;31(2):79-85

language: Italian

Classification of peripheral nerve injury in continuity with the ankle and foot

Giorgetti A. 1, Bardelli M. 2

1 Centro Traumatologico Ortopedico AOUC - Careggi, Firenze
2 Ospedale Santa Maria Annunziata ASL 10 Firenze


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Peripheral nerve injury in continuity with the ankle and foot may result from many causes. But when it manifests as an isolated mononeuropathy, a traumatic or mechanical origin is most likely since other causes (vascular, metabolic, toxic, infectious) generally lead to polyneuropathy or multifocal mononeuropathy. Mononeuropathy following physical injury (macrotrauma) may manifest as painful amputation neuroma following complete trauma or as a so-called neuroma in continuity after subtotal or traction or stretch injury. Mechanical mononeuropathies (microtrauma) may by divided into compression and canalicular variants, depending on whether the compression occurs external to or at the level of well-known predictable anatomic spaces. A useful concept is the pseudocanalicular pattern which describes variants arising from extracanalicular compression. Excellent knowledge of anatomy and function of the nerve trunks of the ankle and foot will help distinguish canalicular from pseudocanalicular mononeuropathy, thus facilitating the appropriate choice of conservative treatment and type of intervention needed to solve the problem.

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