Ilioinguinal nerve Can be caused by hypertrophied abdominal muscles as a result of intensive training Hyperesthesia is common Pain worse with hyperextension of hip Treatment operative surgical release indications failure of nonoperative management Obturator nerve Found in patients with well-developed hip adductors (skaters) Can cause chronic medial thigh pain Nerve conductions studies help establish diagnosis Treatment nonoperative supportive Lateral femoral cutaneous nerve Can lead to pain on lateral aspect of proximal leg meralgia paresthetica Exacerbated by tight belts and prolonged hip flexion Treatment nonoperative PT, NSAIDS postural exercises release of compressive devices Sciatic nerve Can occur anywhere along the course of the nerve Most common locations at level of ischial tuberosity at the piriformis muscle (piriformis syndrome) Saphenous neuritis Compression of the saphenous nerve, usually at Hunter's canal also known as surfer's neuropathy Caused by kneeling for long periods of time Symptoms pain inferior and medial to knee Treatment nonoperative knee pads indications first line of treatment Common peroneal nerve Can be compressed behind fibula by a ganglion cyst or injured by a direct blow Fusion of the proximal tibiofibular joint may be needed to prevent cyst recurrence Superficial peroneal nerve Due to a fascial defect usually ~ 12 cm proximal to lateral malleolus where it exits the fascia of the anterolateral leg Mechanisms include inversion injury fascial defect Presentation numbness and tingling over dorsum of foot worsens with plantar flexion and inversion of foot Treatment nonoperative observation indications usually preferred treatment operative fascial release indications may be indicated in refractory cases or for elite athletes Deep peroneal nerve Can be caused by inferior extensor retinaculum Also known as anterior tarsal syndrome Posterior tibial nerve Also known as Tarsal Tunnel syndrome Lateral plantar nerve Caused by compression of the first branch of the lateral plantar nerve, also known as Baxter nerve (branch to the abductor digiti quinti) common nerve entrapment in the running athlete becomes compressed between fascia of abductor hallucis longus and medial side of quadratus plantae Treatment operative surgical release of abductor hallucis fascia Medial plantar nerve Compression of medial plantar nerve at point where FDL and FHL cross (Knot of Henry) also known as Jogger's foot Most common cause of compression is foot orthotics Treatment nonoperative discontinue foot orthosis Sural nerve Can occur anywhere along the course of the nerve Most vulnerable 12-15mm distal to the tip of the fibula as the foot rests in equinus position Treatment operative surgical release Interdigital neuroma Also known as Morton's neuroma
QUESTIONS 1 of 7 1 2 3 4 5 6 7 Previous Next (OBQ04.6) A 24-year-old male suffered an inversion injury 6 months ago. Since then he has had persistent numbness and tingling across the dorsum of his foot that is worse with plantar flexion and inversion of foot. A release of the involved nerve, shown in Figure V, is performed. Which of the following most likely describes the cause of his symptoms? Review Topic QID: 117 FIGURES: V 1 Compression of the superficial peroneal nerve by fascial band proximal to lateral malleolus 52% (1434/2780) 2 Compression of the superficial peroneal nerve by the superior extensor retinaculum 40% (1125/2780) 3 Compression of the deep peroneal nerve by the inferior extensor retinaculum 3% (88/2780) 4 Compression of the superficial peroneal nerve by a ganglion cyst 2% (57/2780) 5 Compression of the sural nerve 2cm proximal to the tip of the fibula 2% (51/2780) ML 4 Select Answer to see Preferred Response PREFERRED RESPONSE 1 Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ10.251) Figure A is a dissection of the medial aspect of the left ankle and foot. Which of the following nerves indicated in Figure A is most commonly implicated in nerve entrapments in the running athlete? Review Topic QID: 3349 FIGURES: A 1 A 51% (799/1553) 2 B 24% (370/1553) 3 C 3% (44/1553) 4 D 13% (207/1553) 5 E 8% (126/1553) ML 3 Select Answer to see Preferred Response PREFERRED RESPONSE 1 (OBQ07.150) Which nerve innervates the abductor digiti quinti and can be compressed as it travels under the fascia of the abductor hallucis muscle leading to symptoms of plantar heel pain? Review Topic QID: 811 1 Medial plantar 5% (87/1610) 2 Medial calcaneal 2% (31/1610) 3 Sural 1% (13/1610) 4 Superficial peroneal 0% (7/1610) 5 First branch of the lateral plantar nerve 91% (1469/1610) ML 1 Select Answer to see Preferred Response PREFERRED RESPONSE 5 (SBQ07SM.6) A competitive marathoner reports 6 months of pain over the lateral distal leg and dysesthesia over the dorsum of the foot. There is a tender fullness over the distal lateral fibula with a positive Tinel's sign. There is normal motor strength, but pain with passive plantar flexion and inversion of the ankle. The most appropriate surgical treatment is: Review Topic QID: 1391 1 Repair muscle herniation and closure of the fascial defect 8% (111/1426) 2 Fascial release and superficial peroneal neurolysis 82% (1173/1426) 3 Fascial release of all four compartments 2% (34/1426) 4 Superficial peroneal neurectomy 7% (100/1426) 5 Lumbar discectomy 0% (3/1426) ML 2 Select Answer to see Preferred Response PREFERRED RESPONSE 2 (OBQ08.20) A 40-year-old runner complains of heel pain for 4 months. He reports tenderness over the abductor hallucis origin with a positive Tinel's sign radiating to the lateral foot. The pain worsens with prolonged activity. What is the most likely diagnosis? Review Topic QID: 406 1 plantar fasciitis 1% (20/2101) 2 heel fat pad fat atrophy 0% (1/2101) 3 compression of the first branch of the lateral plantar nerve (Baxter's nerve) 88% (1841/2101) 4 achilles tendinitis 0% (3/2101) 5 tarsal tunnel syndrome 11% (231/2101) ML 1 Select Answer to see Preferred Response PREFERRED RESPONSE 3
Upgrade to View Premium Videos Upgrade to View Premium Videos Ganglion Cyst Removal in the Common Peroneal Nerve at the Fibular Head - Dr. Susan Mackinnon Derek Moore Foot & Ankle - Leg Nerve Entrapment Syndromes 9/11/2012 230 views Upgrade to View Premium Videos Upgrade to View Premium Videos Peroneal nerve ganglion cyst decompression Michael Hughes Foot & Ankle - Leg Nerve Entrapment Syndromes 7/2/2012 1155 views