Plantar fascia release and decompression of the first branch of the lateral plantar nerve (Baxter's nerve)

Abstract

Treatment of chronic plantar fasciitis and release of the first calcaneal branch of the lateral plantar nerve (Baxter's nerve). Chronic plantar fasciitis, compression of the first calcaneal branch of the lateral plantar nerve (Baxter's nerve). General medical contraindications to surgical interventions, infection. Longitudinal incision at the medial heel. Exposure of the plantar fascia at its origin on the medial plantar calcaneus. Medial incision of the plantar fascia preserving the lateral portion. Resection of aheel spur, if present. Exposure of the abductor hallucis muscle. Incision of the superficial fascia of the muscle. Retraction of the muscle belly und incision of the deep portion of the fascia, decompression of the nerve. Two weeks partial weight bearing 20 kg in ahealing shoe. Progressively weight bearing using ashoe with astiff sole for another 4weeks. Atotal of 32feet of 27patients with chronic plantar fasciitis and compression of the first branch of the lateral plantar nerve were treated with medial incision of the fascia and anerve decompression. In 24feet acalcaneal spur was resected. Mean follow-up was 25.6 months (12-35months). Preoperative Manchester-Oxford Foot Questionnaire (MOXFQ) score was 52.5 (±9.0), postoperative MOXFQ score was 31.3 (±4.1). Six (18,8%) patients had same or more pain 6weeks postoperatively.;8(25%) patients stated minor complications like swelling, delayed wound healing, temporary hypoesthesia or pain while walking.