Anatomical Landmark Analysis of Medial Plantar Proper Digital Nerve:a Cadaver Dissection Study

ABSTRACT

OBJECTIVE: To analyze the bifurcating points of medial plantar proper digital (MPPD) nerve by using anatomical landmarks on plane coordinates and thus determine the ideal stimulation site for MPPD sensory nerve conduction studies. METHOD: We dissected 10 feet from five adult cadavers and identified the bifurcation points of the MPPD nerve. Two reference lines in relation to anatomical landmarks were defined. A vertical line connecting the mid-point of heel (H) and tip of great toe (G) was defined as the HG line. A transverse line connecting the navicular tuberosity (N) and tuberosity of 5th metatarsal bone (M) was defined as the NM line. The bifurcation points of the 10 MPPD nerves were expressed in X, Y coordinates in relation to these two axis. RESULTS: The bifurcation points were located at approximately 40% (40.0+/-2.4; mean+/-SD) of the HG line from the mid-point of heel (H) and at approximately 37% (36.5+/-3.6) of the NM line from the navicular tuberosity (N). The majority of these points were found to be clustered close to the HG line. CONCLUSION: The data on the MPPD nerve bifurcation points may be useful to localize the appropriate stimulation site that could be used in MPPD nerve conduction studies.