Technique for determining when plantar heel pain can be neural in origin.
The surgeon doing microsurgery will encounter problems related to the heel not only in terms of how to reinnervate the transferred tissue, but also in patients presenting with heel pain. While most heel pain is thought to be related to the plantar fascia arising from the calcaneus, conceptually heel pain can be of neural origin. The technique for documenting sensibility in the heel is described using the Pressure-Specified Sensory Device. Knowledge of calcaneal nerve sensibility can determine whether there is sufficient sensation to prevent ulceration, whether there is a nerve entrapment that would benefit from neurolysis, or whether there is a neuroma that would benefit from resection.
Dellon
A Lee
AL
Department of Plastic Surgery and Neurosurgery, Johns Hopkins University, Baltimore, MD, USA. ALDellon@Dellon.com
D002111:Calcaneus / Q000294:innervation*; D002985:Clinical Protocols; D004867:Equipment Design; D036981:Fasciitis, Plantar / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D009408:Nerve Compression Syndromes / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D009437:Neuralgia / Q000209:etiology*; D009460:Neurologic Examination / Q000295:instrumentation / Q000379:methods; D011312:Pressure; D012677:Sensation; D013979:Tibial Nerve / Q000503:physiopathology