Updated: 5/5/2019

Nerves of the Foot

Topic
Review Topic
0
0
Questions
4
0
0
Evidence
1
0
0
https://upload.orthobullets.com/topic/7004/images/scan_nerves_pl_foot[1]_moved.jpg
https://upload.orthobullets.com/topic/7004/images/sensory plantar foot_moved.jpg
Branches of the Tibial nerve
  • Medial calcaneal nerve
    • innervates
      • plantar medial heel

  • Medial plantar nerve
    • innervates
      • Abductor Hallucis
      • FHB
      • FDB
      • lumbricals to 2nd and 3rd toes
    • at risk
      • proper branch of medial plantar nerve at risk with medial-plantar approach to the tibial sesamoid
  • Lateral plantar nerve
    • innervates (everything else)
      • adductor hallucis
      • quadratus plantae
      • all interossei muscles
      • lateral two lumbricals
      • abductor digiti minimus (via Baxter's nerve - the first branch of LPN
        • Baxter`s nerve
          • courses anterior to the medial tubersosity between the QP and FDB
    • provides sensation to 
      • plantar lateral foot
      • lateral fourth toe
      • fifth toe
  • Physical exam
    • injury to lateral/medial plantar nerve leads to weak or absent MTP flexion (intrinsic minus)
Sural Nerve
  • Provides dorsal sensory in 4th web space (70-80% of time)
  • Most vulnerable during
    • extensile lateral approach to calcaneus
    • screw placement for stress fx of proximal 5th MT
    • Achilles tendon repair - especially percutaneous technique
Deep peroneal Nerve
  • Innervates EDB, and EHB in foot
  • Provides sensation to the first dorsal webspace
  • Found compressed beneath inferior retinaculum in anterior tarsal tunnel syndrome
  • Lateral branch
    • most vulnerable during removal of calcaneonavicular bar
    • during approach for reduction of Lisfranc injury
  • Injury
    • injury leads to weak or absent EDB and EHB function
      • this can be seen with trauma or CMT
Superficial Peroneal Nerve 
  • Medial branch
    • dorsomedial aspect of hallux
      • most vulnerable during bunion surgery   
  • Lateral cutaneous branch
    • emerges from deep fascia 12-15 cm proximal to tip of lateral malleolus
    • most vulnerable with
      • arthroscopic anterolateral portal
      • ORIF of distal fibula fx (especially Weber C)
  • At risk with ankle inversion injuries 
Saphenous Nerve
  • Supplies sensation to 
    • medial side of foot
 

Please rate topic.

Average 3.6 of 9 Ratings

Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine

The complexity of this topic is appropriate for?
How important is this topic for board examinations?
How important is this topic for clinical practice?
Questions (4)
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
ARTICLES (1)
Topic COMMENTS (5)
Private Note