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Article: Anatomy of the Portal Tract for Endoscopic Decompression of the First Branch of the Lateral Plantar Nerve
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TitleAnatomy of the Portal Tract for Endoscopic Decompression of the First Branch of the Lateral Plantar Nerve
 
AuthorsChan, LK1
Lui, TH2
Chan, KB2
 
KeywordsAnatomy
Decompression
Endoscopy
Heel pain
Nerve
Plantar
 
Issue Date2008
 
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/arthro
 
CitationArthroscopy - Journal Of Arthroscopic And Related Surgery, 2008, v. 24 n. 11, p. 1284-1288 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.arthro.2008.06.017
 
AbstractPurpose: Our purpose is to study the anatomy of the portal tract for endoscopic decompression of the first branch of the lateral plantar nerve. Methods: The anatomy of the portals and portal tract with endoscopic release of the first branch of the lateral plantar nerve was studied in 12 feet in 6 cadaveric bodies. Results: The proximal portal is located at the fascial opening for the first branch of the lateral plantar nerve and is about 16 mm inferior and 23 mm posterior to the tip of the medial malleolus. The distal portal is located at the inferior edge of the deep fascia of the abductor hallucis muscle and just distal to the medial calcaneal tubercle. The portal tract is deep to the deep surface of the whole width of the deep abductor fascia. In 1 of 12 specimens, the nerve lay superficial to a rod placed between the portals, whereas the nerve was deep to the rod in the remaining 11 specimens. In all specimens the first branch of the lateral plantar nerve, after it pierced the deep fascia of the abductor hallucis at the fascial defect, ran anteriorly and distally, approximately parallel to the direction of the rod. Conclusions: The proximal portal for endoscopic decompression of the first branch of the lateral plantar nerve is located at the fascial opening for the first branch of the lateral plantar nerve. This can be consistently located with the Wissinger rod technique. The portal tract thus created is effective for deep abductor fascia release. However, percutaneous release without endoscopic visualization of the first branch of the lateral plantar nerve is not safe because of the potential risk of nerve injury, because the nerve can be sandwiched between the instrument and the deep abductor fascia without being noticed. Clinical Relevance: The study confirmed the first branch of the lateral plantar nerve can be effectively released endoscopically. © 2008 Arthroscopy Association of North America.
 
ISSN0749-8063
2012 Impact Factor: 3.103
2012 SCImago Journal Rankings: 2.546
 
DOIhttp://dx.doi.org/10.1016/j.arthro.2008.06.017
 
ISI Accession Number IDWOS:000261272700013
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorChan, LK
 
dc.contributor.authorLui, TH
 
dc.contributor.authorChan, KB
 
dc.date.accessioned2010-05-31T04:22:25Z
 
dc.date.available2010-05-31T04:22:25Z
 
dc.date.issued2008
 
dc.description.abstractPurpose: Our purpose is to study the anatomy of the portal tract for endoscopic decompression of the first branch of the lateral plantar nerve. Methods: The anatomy of the portals and portal tract with endoscopic release of the first branch of the lateral plantar nerve was studied in 12 feet in 6 cadaveric bodies. Results: The proximal portal is located at the fascial opening for the first branch of the lateral plantar nerve and is about 16 mm inferior and 23 mm posterior to the tip of the medial malleolus. The distal portal is located at the inferior edge of the deep fascia of the abductor hallucis muscle and just distal to the medial calcaneal tubercle. The portal tract is deep to the deep surface of the whole width of the deep abductor fascia. In 1 of 12 specimens, the nerve lay superficial to a rod placed between the portals, whereas the nerve was deep to the rod in the remaining 11 specimens. In all specimens the first branch of the lateral plantar nerve, after it pierced the deep fascia of the abductor hallucis at the fascial defect, ran anteriorly and distally, approximately parallel to the direction of the rod. Conclusions: The proximal portal for endoscopic decompression of the first branch of the lateral plantar nerve is located at the fascial opening for the first branch of the lateral plantar nerve. This can be consistently located with the Wissinger rod technique. The portal tract thus created is effective for deep abductor fascia release. However, percutaneous release without endoscopic visualization of the first branch of the lateral plantar nerve is not safe because of the potential risk of nerve injury, because the nerve can be sandwiched between the instrument and the deep abductor fascia without being noticed. Clinical Relevance: The study confirmed the first branch of the lateral plantar nerve can be effectively released endoscopically. © 2008 Arthroscopy Association of North America.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationArthroscopy - Journal Of Arthroscopic And Related Surgery, 2008, v. 24 n. 11, p. 1284-1288 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.arthro.2008.06.017
 
dc.identifier.doihttp://dx.doi.org/10.1016/j.arthro.2008.06.017
 
dc.identifier.epage1288
 
dc.identifier.hkuros156354
 
dc.identifier.isiWOS:000261272700013
 
dc.identifier.issn0749-8063
2012 Impact Factor: 3.103
2012 SCImago Journal Rankings: 2.546
 
dc.identifier.issue11
 
dc.identifier.pmid18971060
 
dc.identifier.scopuseid_2-s2.0-54149097121
 
dc.identifier.spage1284
 
dc.identifier.urihttp://hdl.handle.net/10722/60940
 
dc.identifier.volume24
 
dc.languageeng
 
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/arthro
 
dc.publisher.placeUnited States
 
dc.relation.ispartofArthroscopy - Journal of Arthroscopic and Related Surgery
 
dc.relation.referencesReferences in Scopus
 
dc.subjectAnatomy
 
dc.subjectDecompression
 
dc.subjectEndoscopy
 
dc.subjectHeel pain
 
dc.subjectNerve
 
dc.subjectPlantar
 
dc.titleAnatomy of the Portal Tract for Endoscopic Decompression of the First Branch of the Lateral Plantar Nerve
 
dc.typeArticle
 
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<subject>Anatomy</subject>
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Author Affiliations
  1. The University of Hong Kong Li Ka Shing Faculty of Medicine
  2. North District Hospital Hong Kong