Plantar fascia release and decompression of the first branch of the lateral plantar nerve (Baxter's nerve)

Objective Treatment of chronic plantar fasciitis and release of the first calcaneal branch of the lateral plantar nerve (Baxter's nerve). Indications Chronic plantar fasciitis, compression of the first calcaneal branch of the lateral plantar nerve (Baxter's nerve). Contraindications General medical contraindications to surgical interventions, infection. Surgical technique Longitudinal incision at the medial heel. Exposure of the plantar fascia at its origin on the medial plantar calcaneus. Medial incision of the plantar fascia preserving the lateral portion. Resection of a heel spur, if present. Exposure of the abductor hallucis muscle. Incision of the superficial fascia of the muscle. Retraction of the muscle belly und incision of the deep portion of the fascia, decompression of the nerve. Postoperative management Two weeks partial weight bearing 20 kg in a healing shoe. Progressively weight bearing using a shoe with a stiff sole for another 4 weeks. Results A total of 32 feet of 27 patients with chronic plantar fasciitis and compression of the first branch of the lateral plantar nerve were treated with medial incision of the fascia and a nerve decompression. In 24 feet a calcaneal spur was resected. Mean follow-up was 25.6 months (12-35 months). Preoperative Manchester-Oxford Foot Questionnaire (MOXFQ) score was 52.5 (+/- 9.0), postoperative MOXFQ score was 31.3 (+/- 4.1). Six (18,8%) patients had same or more pain 6 weeks postoperatively.;8 (25%) patients stated minor complications like swelling, delayed wound healing, temporary hypoesthesia or pain while walking.