The Proper Digital Nerve, Vitallium Stem Arthroplasty, and Some Thoughts About Foot Surgery in General

A Retrospective Cohort Study of the BioPro® Hemiarthroplasty Prosthesis

“…Our results compare with previous studies that observed good clinical and subjective results after use of the proximal phalangeal resurfacing implant (1,3,(11)(12)(13)(14). Based on our experience with the implant, we feel that it offers a number of advantages, including minimal postoperative debilitation and reliable pain relief, and similar findings have also been previously noted (1,3).…”

Anatomical study of the medial plantar proper digital nerve using ultrasound

“…The nerve pierces the plantar fascia posterior to the tarsometatarsal joint and courses distally through subcutaneous tissues to supply innervation to the medial plantar aspect of the first MTPJ, hallux and tip of the toe [3][4][5]. Because of its particularly long course and superficial position, the MPPDN may be subject to trauma, which results in a compression neuropathy at the level of the first MTPJ known as Joplin's neuroma [6,10]. Symptoms of Joplin's neuroma are sharp pain mixed with burning, tingling, numbness and paraesthesia to the medial and plantar aspects of the first MTPJ and hallux [3].…”

“…Because of its particularly long course and superficial position, the MPPDN may be subject to trauma, which results in a condition known as Joplin's neuroma [6]. Repetitive microtrauma to the nerve during gait may occur in patients who are anatomically predisposed by the presence of a first metatarsal prominent bony ridge.…”

Sensory Nerve Neuromas—Leading to Failed Foot Surgery

“…roma. 2,3,11,12,15,17,18,21,22 Care must be taken to differentiate causalgia pain from neuroma pain." Both may be associated with a reflex sympathetic dystrophy (RSD), but the treatment of each is different.…”