Sensory Nerve Conduction in Branches of Common Interdigital Nerves: A New Technique for Normal Controls and Patients With Morton's Neuroma
Adult
Male
Nerve conduction
Electromyography
Electrodiagnosis
Neural Conduction
Action Potentials
Middle Aged
Toes
Metatarsalgia
Magnetic Resonance Imaging
Morton's neuroma
Neuroma
03 medical and health sciences
0302 clinical medicine
Reaction Time
Humans
Female
Peripheral Nerves
Tibial Nerve
Common plantar interdigital nerve
DOI:
10.1097/wnp.0b013e3181e0a980
Publication Date:
2010-05-18T06:29:57Z
AUTHORS (5)
ABSTRACT
In this article, a new electrodiagnostic approach is described for patients with Morton's neuroma. The new method is based on the anatomic fact that the two branches of the common plantar interdigital nerves innervate the lateral side of one toe and the medial side the next one. This study included 20 normal subjects (aged 28-58 years, 10 men and 10 women) and 4 patients with Morton's neuroma (aged 44-52 years, 4 women). The branches of adjacent common plantar interdigital nerves that innerve one toe were stimulated superficially and separately with half of one toe covered with a piece of medical tape. The recordings were obtained on the posterior tibial nerve at the medial malleolus with needle electrodes. Thus, the difference in latencies of obtained sensory nerve action potentials on the posterior tibial nerve with needle electrode was measured. From normal subjects' data, it was determined that a latency difference value of above 0.17 milliseconds (mean +/- 2.5 SD) in one toe was abnormal. All of the patients with Morton's neuroma showed abnormal interlatency difference values. This new method, which we have developed, is more sensitive, simple to use, does not require extra equipment, and does not cause excessive pain. We suggest that interlatency difference between branches of the common plantar interdigital nerves is a useful and sensitive method for the diagnosis of Morton's neuroma.
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