Dorsomedial cutaneous nerve syndrome: treatment with nerve transection and burial into bone.

Abstract:

:Damage to the dorsomedial cutaneous nerve of the foot, which innervates the medial hallux, may occur with crush injury or iatrogenically with bunion surgery. Severe neuritic pain after bunion surgery may alert the surgeon that this small nerve has been damaged. The term "dorsomedial cutaneous nerve syndrome" is suggested for this condition, and nine patients with such forefoot presentations, all of which were unresponsive to nonoperative interventions, are described. The nerve had been either transected or bound in scar tissue; in these nine cases, the nerve was then resected and buried in the proximal aspect of the first metatarsal or the medial cuneiform. Most patients underwent an additional procedure (other than the nerve procedure), such as revision bunionectomy or arthrodesis, but all felt they could clearly delineate nerve pain from bone or joint pain. All patients experienced marked relief of their symptoms, usually within days after the surgery, and were satisfied with the results. The verbal analog pain score, on a scale of 0 (no pain) to 10 (pain requiring amputation), improved from a preoperative level of 8.6 to a postoperative level of 2.0. Resection and burial of this nerve appears to be a useful treatment for neuritis unresponsive to nonoperative measures.

journal_name

Foot Ankle Int

authors

Miller SD

doi

10.1177/107110070102200305

keywords:

subject

Has Abstract

pub_date

2001-03-01 00:00:00

pages

198-202

issue

3

eissn

1071-1007

issn

1944-7876

journal_volume

22

pub_type

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