Nerve Entrapment Syndromes of the Lower Extremity Questions & Answers

1. Dellon AL. The four medial ankle tunnels: a critical review of perceptions of tarsal tunnel syndrome and neuropathy. Neurosurg Clin N Am. 2008 Oct. 19 (4):629-48, vii. [QxMD MEDLINE Link].

2. Baxter DE, Thigpen CM. Heel pain--operative results. Foot Ankle. 1984 Jul-Aug. 5 (1):16-25. [QxMD MEDLINE Link].

3. Morton TG. The Classic. A peculiar and painful affection of the fourth metatarso-phalangeal articulation. Clin Orthop Relat Res. 1979 Jul-Aug. 4-9. [QxMD MEDLINE Link].

4. Kim JY, Choi JH, Park J, Wang J, Lee I. An anatomical study of Morton's interdigital neuroma: the relationship between the occurring site and the deep transverse metatarsal ligament (DTML). Foot Ankle Int. 2007 Sep. 28 (9):1007-10. [QxMD MEDLINE Link].

5. Tubbs RS, Miller J, Loukas M, Shoja MM, Shokouhi G, Cohen-Gadol AA. Surgical and anatomical landmarks for the perineal branch of the posterior femoral cutaneous nerve: implications in perineal pain syndromes. Laboratory investigation. J Neurosurg. 2009 Aug. 111 (2):332-5. [QxMD MEDLINE Link].

6. Carai A, Fenu G, Sechi E, Crotti FM, Montella A. Anatomical variability of the lateral femoral cutaneous nerve: findings from a surgical series. Clin Anat. 2009 Apr. 22 (3):365-70. [QxMD MEDLINE Link].

7. Havel PE, Ebraheim NA, Clark SE, Jackson WT, DiDio L. Tibial nerve branching in the tarsal tunnel. Foot Ankle. 1988 Dec. 9 (3):117-9. [QxMD MEDLINE Link].

8. Vieira RL, Rosenberg ZS, Kiprovski K. MRI of the distal biceps femoris muscle: normal anatomy, variants, and association with common peroneal entrapment neuropathy. AJR Am J Roentgenol. 2007 Sep. 189 (3):549-55. [QxMD MEDLINE Link].

9. Ducic I, Dellon AL, Graw KS. The clinical importance of variations in the surgical anatomy of the superficial peroneal nerve in the mid-third of the lateral leg. Ann Plast Surg. 2006 Jun. 56 (6):635-8. [QxMD MEDLINE Link].

10. Canella C, Demondion X, Guillin R, Boutry N, Peltier J, Cotten A. Anatomic study of the superficial peroneal nerve using sonography. AJR Am J Roentgenol. 2009 Jul. 193 (1):174-9. [QxMD MEDLINE Link].

11. Aktan Ikiz ZA, Ucerler H, Uygur M. Dimensions of the anterior tarsal tunnel and features of the deep peroneal nerve in relation to clinical application. Surg Radiol Anat. 2007 Oct. 29 (7):527-30. [QxMD MEDLINE Link].

12. Shin JH, Howard FM. Abdominal wall nerve injury during laparoscopic gynecologic surgery: incidence, risk factors, and treatment outcomes. J Minim Invasive Gynecol. 2012 Jul-Aug. 19 (4):448-53. [QxMD MEDLINE Link].

13. Soyer T, Tosun A, Keleş I, Inal E, Cesur O, Cakmak M. Electrophysiologic evaluation of genitofemoral nerve in children with inguinal hernia repair. J Pediatr Surg. 2008 Oct. 43 (10):1865-8. [QxMD MEDLINE Link].

14. Weiss JM, Tolo V. Femoral nerve palsy following iliacus hematoma. Orthopedics. 2008 Feb. 31 (2):178. [QxMD MEDLINE Link].

15. Kurt S, Kaplan Y, Karaer H, Erkorkmaz U. Femoral nerve involvement in diabetics. Eur J Neurol. 2009 Mar. 16 (3):375-9. [QxMD MEDLINE Link].

16. Flu HC, Breslau PJ, Hamming JF, Lardenoye JW. A prospective study of incidence of saphenous nerve injury after total great saphenous vein stripping. Dermatol Surg. 2008 Oct. 34 (10):1333-9. [QxMD MEDLINE Link].

17. Langebrekke A, Qvigstad E. Endometriosis entrapment of the obturator nerve after previous cervical cancer surgery. Fertil Steril. 2009 Feb. 91 (2):622-3. [QxMD MEDLINE Link].

18. Wieman TJ, Patel VG. Treatment of hyperesthetic neuropathic pain in diabetics. Decompression of the tarsal tunnel. Ann Surg. 1995 Jun. 221 (6):660-4; discussion 664-5. [QxMD MEDLINE Link]. [Full Text].

19. Keck C. The tarsal-tunnel Syndrome. J Bone Joint Surg. 1962. 44(1):180-2.

20. Sammarco GJ, Chang L. Outcome of surgical treatment of tarsal tunnel syndrome. Foot Ankle Int. 2003 Feb. 24 (2):125-31. [QxMD MEDLINE Link].

21. Cimino WR. Tarsal tunnel syndrome: review of the literature. Foot Ankle. 1990 Aug. 11 (1):47-52. [QxMD MEDLINE Link].

22. Gould N, Alvarez R. Bilateral tarsal tunnel syndrome caused by varicosities. Foot Ankle. 1983 Mar-Apr. 3 (5):290-2. [QxMD MEDLINE Link].

23. Turan I, Rivero-Melián C, Guntner P, Rolf C. Tarsal tunnel syndrome. Outcome of surgery in longstanding cases. Clin Orthop Relat Res. 1997 Oct. 151-6. [QxMD MEDLINE Link].

24. Budak F, Bamaç B, Ozbek A, Kutluay P, Komsuoğlu S. Nerve conduction studies of lower extremities in pes planus subjects. Electromyogr Clin Neurophysiol. 2001 Oct-Nov. 41 (7):443-6. [QxMD MEDLINE Link].

25. Labib SA, Gould JS, Rodriguez-del-Rio FA, Lyman S. Heel pain triad (HPT): the combination of plantar fasciitis, posterior tibial tendon dysfunction and tarsal tunnel syndrome. Foot Ankle Int. 2002 Mar. 23 (3):212-20. [QxMD MEDLINE Link].

26. Trepman E, Kadel NJ, Chisholm K, Razzano L. Effect of foot and ankle position on tarsal tunnel compartment pressure. Foot Ankle Int. 1999 Nov. 20 (11):721-6. [QxMD MEDLINE Link].

27. Kaminsky F. Peroneal palsy by crossing the legs. JAMA. 1947. 134:206.

28. Piton C, Fabre T, Lasseur E, André D, Geneste M, Durandeau A. [Common fibular nerve lesions. Etiology and treatment. Apropos of 146 cases with surgical treatment]. Rev Chir Orthop Reparatrice Appar Mot. 1997. 83 (6):515-21. [QxMD MEDLINE Link].

29. Tseng KF, Hsu HC, Wang FC, Fong YC. Nerve sheath ganglion of the tibial nerve presenting as a Baker's cyst: a case report. Knee Surg Sports Traumatol Arthrosc. 2006 Sep. 14 (9):880-4. [QxMD MEDLINE Link].

30. Sabapathy SR, Langer V, Bhatnagar A. Intraneural lipoma associated with a branch of the superficial peroneal nerve. J Foot Ankle Surg. 2008 Nov-Dec. 47 (6):576-8. [QxMD MEDLINE Link].

31. Ha'Eri GB, Fornasier VL, Schatzker J. Morton's neuroma--pathogenesis and ultrastructure. Clin Orthop Relat Res. 1979 Jun. 256-9. [QxMD MEDLINE Link].

32. Shereff MJ, Grande DA. Electron microscopic analysis of the interdigital neuroma. Clin Orthop Relat Res. 1991 Oct. 296-9. [QxMD MEDLINE Link].

33. Morscher E, Ulrich J, Dick W. Morton's intermetatarsal neuroma: morphology and histological substrate. Foot Ankle Int. 2000 Jul. 21 (7):558-62. [QxMD MEDLINE Link].

34. Levitsky KA, Alman BA, Jevsevar DS, Morehead J. Digital nerves of the foot: anatomic variations and implications regarding the pathogenesis of interdigital neuroma. Foot Ankle. 1993 May. 14 (4):208-14. [QxMD MEDLINE Link].

35. Anselmi SJ. Common peroneal nerve compression. J Am Podiatr Med Assoc. 2006 Sep-Oct. 96 (5):413-7. [QxMD MEDLINE Link].

36. Linscheid RL, Burton RC, Fredericks EJ. Tarsal-tunnel syndrome. South Med J. 1970 Nov. 63 (11):1313-23. [QxMD MEDLINE Link].

37. Styf J. Entrapment of the superficial peroneal nerve. Diagnosis and results of decompression. J Bone Joint Surg Br. 1989 Jan. 71 (1):131-5. [QxMD MEDLINE Link].

38. Oh SJ, ed. Clinical Electromyography: Nerve Conduction Studies. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2003.

39. Kaplan PE, Kernahan WT Jr. Tarsal tunnel syndrome: an electrodiagnostic and surgical correlation. J Bone Joint Surg Am. 1981 Jan. 63 (1):96-9. [QxMD MEDLINE Link].

40. Golovchinsky V. Double crush syndrome in lower extremities. Electromyogr Clin Neurophysiol. 1998 Mar. 38 (2):115-20. [QxMD MEDLINE Link].

41. Kankanala G, Jain AS. The operational characteristics of ultrasonography for the diagnosis of plantar intermetatarsal neuroma. J Foot Ankle Surg. 2007 Jul-Aug. 46 (4):213-7. [QxMD MEDLINE Link].

42. Redd RA, Peters VJ, Emery SF, Branch HM, Rifkin MD. Morton neuroma: sonographic evaluation. Radiology. 1989 May. 171 (2):415-7. [QxMD MEDLINE Link].

43. Quinn TJ, Jacobson JA, Craig JG, van Holsbeeck MT. Sonography of Morton's neuromas. AJR Am J Roentgenol. 2000 Jun. 174 (6):1723-8. [QxMD MEDLINE Link].

44. Terk MR, Kwong PK, Suthar M, Horvath BC, Colletti PM. Morton neuroma: evaluation with MR imaging performed with contrast enhancement and fat suppression. Radiology. 1993 Oct. 189 (1):239-41. [QxMD MEDLINE Link].

45. Zanetti M, Strehle JK, Kundert HP, Zollinger H, Hodler J. Morton neuroma: effect of MR imaging findings on diagnostic thinking and therapeutic decisions. Radiology. 1999 Nov. 213 (2):583-8. [QxMD MEDLINE Link].

46. Zanetti M, Strehle JK, Zollinger H, Hodler J. Morton neuroma and fluid in the intermetatarsal bursae on MR images of 70 asymptomatic volunteers. Radiology. 1997 May. 203 (2):516-20. [QxMD MEDLINE Link].

47. Resch S, Stenström A, Jònsson A, Jonsson K. The diagnostic efficacy of magnetic resonance imaging and ultrasonography in Morton's neuroma: a radiological-surgical correlation. Foot Ankle Int. 1994 Feb. 15 (2):88-92. [QxMD MEDLINE Link].

48. Mann RA, Reynolds JC. Interdigital neuroma--a critical clinical analysis. Foot Ankle. 1983 Jan-Feb. 3 (4):238-43. [QxMD MEDLINE Link].

49. Rasmussen MR, Kitaoka HB, Patzer GL. Nonoperative treatment of plantar interdigital neuroma with a single corticosteroid injection. Clin Orthop Relat Res. 1996 May. 188-93. [QxMD MEDLINE Link].

50. Krähenbühl L, Striffeler H, Baer HU, Büchler MW. Retroperitoneal endoscopic neurectomy for nerve entrapment after hernia repair. Br J Surg. 1997 Feb. 84 (2):216-9. [QxMD MEDLINE Link].

51. Lyon EK. Genito-femoral causalgia. Can Med Assoc J. 1945. 53:213-6.

52. Magee RK. Genito-femoral causalgia. Can Med Assoc J. 1942. 46:326-9.

53. Harms BA, DeHaas DR Jr, Starling JR. Diagnosis and management of genitofemoral neuralgia. Arch Surg. 1984 Mar. 119 (3):339-41. [QxMD MEDLINE Link].

54. Chen CK, Phui VE, Saman MA. Alcohol neurolysis of lateral femoral cutaneous nerve for recurrent meralgia paresthetica. Agri. 2012. 24 (1):42-4. [QxMD MEDLINE Link].

55. Son BC, Kim DR, Kim IS, Hong JT, Sung JH, Lee SW. Neurolysis for meralgia paresthetica. J Korean Neurosurg Soc. 2012 Jun. 51 (6):363-6. [QxMD MEDLINE Link]. [Full Text].

56. Khalil N, Nicotra A, Rakowicz W. Treatment for meralgia paraesthetica. Cochrane Database Syst Rev. 2008 Jul 16. CD004159. [QxMD MEDLINE Link].

57. Watson TS, Anderson RB, Davis WH, Kiebzak GM. Distal tarsal tunnel release with partial plantar fasciotomy for chronic heel pain: an outcome analysis. Foot Ankle Int. 2002 Jun. 23 (6):530-7. [QxMD MEDLINE Link].

58. Bailie DS, Kelikian AS. Tarsal tunnel syndrome: diagnosis, surgical technique, and functional outcome. Foot Ankle Int. 1998 Feb. 19 (2):65-72. [QxMD MEDLINE Link].

59. Barker AR, Rosson GD, Dellon AL. Outcome of neurolysis for failed tarsal tunnel surgery. J Reconstr Microsurg. 2008 Feb. 24 (2):111-8. [QxMD MEDLINE Link].

60. Lowenstein J, Towers J, Tomaino MM. Intraneural ganglion of the peroneal nerve: importance of timely diagnosis. Am J Orthop (Belle Mead NJ). 2001 Nov. 30 (11):816-9. [QxMD MEDLINE Link].

61. Fabre T, Piton C, Andre D, Lasseur E, Durandeau A. Peroneal nerve entrapment. J Bone Joint Surg Am. 1998 Jan. 80 (1):47-53. [QxMD MEDLINE Link].

62. Styf J, Morberg P. The superficial peroneal tunnel syndrome. Results of treatment by decompression. J Bone Joint Surg Br. 1997 Sep. 79 (5):801-3. [QxMD MEDLINE Link].

63. Sridhara CR, Izzo KL. Terminal sensory branches of the superficial peroneal nerve: an entrapment syndrome. Arch Phys Med Rehabil. 1985 Nov. 66 (11):789-91. [QxMD MEDLINE Link].

64. Johnston EC, Howell SJ. Tension neuropathy of the superficial peroneal nerve: associated conditions and results of release. Foot Ankle Int. 1999 Sep. 20 (9):576-82. [QxMD MEDLINE Link].

65. Dellon AL, Aszmann OC. Treatment of superficial and deep peroneal neuromas by resection and translocation of the nerves into the anterolateral compartment. Foot Ankle Int. 1998 May. 19 (5):300-3. [QxMD MEDLINE Link].

66. Dellon AL. Deep peroneal nerve entrapment on the dorsum of the foot. Foot Ankle. 1990 Oct. 11 (2):73-80. [QxMD MEDLINE Link].

67. Miki RA, Lawrence JP, Gillon TJ, Lawrence BD, Zell RA. Anterior tibial artery and deep peroneal nerve entrapment in spiral distal third tibia fracture. Orthopedics. 2008 Dec. 31 (12):[QxMD MEDLINE Link].

68. Coughlin MJ, Pinsonneault T. Operative treatment of interdigital neuroma. A long-term follow-up study. J Bone Joint Surg Am. 2001 Sep. 83 (9):1321-8. [QxMD MEDLINE Link].

69. Dereymaeker G, Schroven I, Steenwerckx A, Stuer P. Results of excision of the interdigital nerve in the treatment of Morton's metatarsalgia. Acta Orthop Belg. 1996 Mar. 62 (1):22-5. [QxMD MEDLINE Link].

70. Gauthier G. Thomas Morton's disease: a nerve entrapment syndrome. A new surgical technique. Clin Orthop Relat Res. 1979 Jul-Aug. 90-2. [QxMD MEDLINE Link].

71. Weinfeld SB, Myerson MS. Interdigital Neuritis: Diagnosis and Treatment. J Am Acad Orthop Surg. 1996 Nov. 4 (6):328-335. [QxMD MEDLINE Link].

72. Benedetti RS, Baxter DE, Davis PF. Clinical results of simultaneous adjacent interdigital neurectomy in the foot. Foot Ankle Int. 1996 May. 17 (5):264-8. [QxMD MEDLINE Link].

73. Thompson FM, Deland JT. Occurrence of two interdigital neuromas in one foot. Foot Ankle. 1993 Jan. 14 (1):15-7. [QxMD MEDLINE Link].

74. Hort KR, DeOrio JK. Adjacent interdigital nerve irritation: single incision surgical treatment. Foot Ankle Int. 2002 Nov. 23 (11):1026-30. [QxMD MEDLINE Link].

Minoo Hadjari Hollis, MD Orthopedic Surgeon, Sound Orthopedics and Foot and Ankle Center

Minoo Hadjari Hollis, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Foot and Ankle Society

Disclosure: Nothing to disclose.

David E Lemay, MD Consulting Staff, Pensacola PM&R Group, PA and Gulf Coast Orthopaedic Specialists, PA

Disclosure: Nothing to disclose.

Thomas M DeBerardino, MD, FAAOS, FAOA Professor of Orthopaedic Surgery, University of Texas Health Science Center at San Antonio, Joe R and Teresa Lozano Long School of Medicine; Professor of Orthopaedic Surgery and Faculty of Sports Medicine Fellowship, Baylor College of Medicine; Sports Medicine Orthopaedic Surgeon, Department of Orthopaedics, UT Health San Antonio; Consulting Surgeon, Sports Medicine, Arthroscopy and Reconstruction of the Knee, Hip and Shoulder

Thomas M DeBerardino, MD, FAAOS, FAOA is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Orthopaedic Society for Sports Medicine, Arthroscopy Association of North America, Clinical Orthopaedic Society, Herodicus Society, International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Arthrex, Inc.; MTF; Aesculap; Conmed; JRF<br/>Received research grant from: Arthrex, Inc.; MTF.

John S Early, MD Foot/Ankle Specialist, Texas Orthopaedic Associates, LLP; Co-Director, North Texas Foot and Ankle Fellowship, Baylor University Medical Center

John S Early, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, American Orthopaedic Foot and Ankle Society, Orthopaedic Trauma Association, and Texas Medical Association

Disclosure: AO North America Honoraria Speaking and teaching; Stryker Consulting fee Consulting; Biomet Consulting fee Consulting; AO North America Grant/research funds fellowship funding; MMI inc Honoraria Speaking and teaching; Osteomed Consulting fee Consulting; MedHab Inc Management position

Robert P Jensen, MD Consulting Staff, Pensacola PM&R Group, PA

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

• Print this section
• Print the entire contents of
• Print the entire contents of article