Clinical History
82-year-old man with left midfoot pain and advanced naviculocuneiform joint arthrosis on radiography but lacking response to steroid injection.
Diagnosis: Deep Peroneal Nerve Mediated Pain From Midfoot Arthrosis
Arthritic pain is thought to result from periarticular innervation of osteophytes and joint capsules.
The deep peroneal nerve innervates the second and third TMT joints, as well as the naviculocuneiform and additional TMT joints in many people.
Therefore, deep peroneal neurectomy is a treatment option for painful midfoot arthropathy.
Ultrasound-guided diagnostic perineural anesthetic injection is performed prior to surgery to assess degree of potential efficacy of the neurectomy.