Anatomy of Lateral Plantar Nerve

Courtesy: Prof Nabile Ebraheim, University of Toledo, Ohio, USA

• The lateral plantar nerve is a branch of the posterior tibial nerve, which originates from the sciatic nerve.
• Around the medial side of the ankle close to the tarsal tunnel, the posterior tibial nerve divides into the medial and lateral plantar nerves.
• Thickening of the flexor retinaculum will cause compression of the posterior tibial nerve, which is called tarsal tunnel syndrome.
• When drawing a line between the medial malleolus and the calcaneus, the posterior tibial nerve divides into branches within 2 cm from this axis.
• The first branch of the lateral plantar nerve is called the Baxter’s nerve and it is involved in chronic heel related pain.
• The pain associated with the Baxter’s nerve is very similar to the pain associated with plantar fasciitis.
• Compression of the first branch of the lateral plantar nerve.
• The first branch gets compressed between the fascia of the abductor halluces muscle and the medial side of the quadratus plantae muscle.
• This condition may require surgical release of the abductor halluces fascia if conservative treatment and injection does not produce any effect.

The lateral plantar nerve is important because:

• It is similar to the ulnar nerve in the hand •It supplies most of the intrinsic muscles of the foot •It supplies the Baxter’s nerve branch
• It can be injured during surgery (rod placement from the heel).
• Hardware placement prominence near the sustentaculum tali can injure the flexor hallucis longus tendon and also can injure the lateral plantar nerve