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bibliography * The PainScience Bibliography contains plain language summaries of thousands of scientific papers and others sources, like a specialized blog. This page is about a single scientific paper in the bibliography, Govsa 2006.

Variations in the anatomy of the medial and inferior calcaneal nerves

updated
Govsa F, Bilge O, Ozer MA. Variations in the origin of the medial and inferior calcaneal nerves. Arch Orthop Trauma Surg. 2006 Jan;126(1):6–14. PubMed #16333630.
Tags: anatomy, counter-intuitive, foot, plantar fasciitis, leg, limbs, pain problems, overuse injury, injury, tendinosis

PainSci summary of Govsa 2006?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★☆☆?3-star ratings are for typical studies with no more (or less) than the usual common problems. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.

This is a dissection study of nerves on the inside of the heel, that may be related to plantar fasciitis, heel pain syndrome and fat pad disorders. The anatomy was quite unpredictable! For instance, they found one medial calcaneal nerve in 38% of the feet, two medial calcaneal nerves in 46%, three medial calcaneal nerves in 12% and four medial calcaneal nerves in 4%. As summarized by Nicholl et al: “As the innervations of the medial aspect of the heel appear to be widely variable, it would be difficult to guarantee that a percutaneous [through the skin] incision to the plantar fascia would not cause accidental neural damage.”

~ Paul Ingraham

original abstractAbstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

INTRODUCTION: Entrapment of the medial heel region nerves is often mentioned as a possible cause of heel pain. Some authors have suggested that the medial and inferior calcaneal nerves may be involved in such heel pain, including plantar fasciitis, heel pain syndrome and fat pad disorders. The aim of this study was to give a detailed description of the medial heel that would determine the variability and pattern of the medial and inferior calcaneal nerves, as well as to relate these findings to the currently used incision line for tarsal tunnel, fixations of fractures with external nailing, medial displacement osteotomy and nerve blocks in podiatric medicine.

MATERIALS AND METHODS: The origin, relationship, distribution, variability and innervation of medial and inferior calcaneal nerves were studied with the use of a 3.5 power loupe magnification for dissection of 25 adult male feet of formalin-fixed cadavers. The medial heel was found to be innervated by just one medial calcaneal nerve in 38% of the feet, by two medial calcaneal nerves in 46%, by three medial calcaneal nerves in 12% and by four medial calcaneal nerves in 4%. An origin for a medial calcaneal nerve from the medial plantar nerve was found in 46% of the feet. This nerve most often innervates the skin of the posteromedial arch.

RESULTS: In our dissection, the rate of occurrence of the medial and inferior calcaneal nerves in medial heel region was 100%. When compared with the inferior calcaneal nerve, the medial calcaneal nerve was posterior, superior and thicker. The inferior calcaneal nerve supplies deeper structures. In the majority of the cases, inferior calcaneal nerve aroused from the lateral plantar nerve, but it may also arise from the tibial nerve, sometimes in a common origin with the medial calcaneal nerve.

CONCLUSIONS: Knowledge of fine anatomy of the calcaneal nerves is necessary to ensure safe surgical intervention in the medial heel region.

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These two articles on PainScience.com cite Govsa 2006 as a source:


This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights: