![]() ![]() the superior border of the inferior extensor retinaculum. ![]() ganglion cysts, tumors, aneurysm of the dorsalis pedis artery)Įntrapment or injury can happen at several sites above, within or distal to the anterior tarsal tunnel including 1-3: talonavicular, navicular-cuneiform or tarsometatarsal osteophytes.repetitive microtrauma (due to footwear).EtiologyĬauses of deep peroneal nerve entrapment syndrome include the following 1-5: Whereas nerve compression above the anterior tarsal tunnel can lead to both motor and sensory symptoms 1 nerve compression within the anterior tarsal tunnel or distal to it typically causes pain and sensory deficits without significant motor loss 3. Depending on the location of the entrapment or injury this will lead to respective sensory and/or motor symptoms including pain, paresthesia and weakness and possibly denervation changes. Sensory fibers innervate the ankle joint, sinus tarsi the tarsal and second to fourth metatarsophalangeal joints as well as to the first web space 1. The deep peroneal nerve supplies motor innervation to the tibialis anterior, extensor hallucis longus, extensor digitorum longus, peroneus tertius within the lower leg and extensor hallucis and digitorum brevis muscles at the superolateral aspect of the foot 1,5. There might be a Tinel sign with the percussion of the foot in the respective area leading to tingling in the first web space 2,3.ĭepending on the level of nerve compression symptoms might also include weakness of hallux extension if the entrapment site is above the anterior tarsal tunnel 1 or pain radiating to the lateral aspect of the foot if only the lateral branch is involved 1. Presenting symptoms include sharp pain at the dorsum of the foot with numbness and tingling radiating into the first web space 1-3. Imaging such as MRI might provide additional clues concerning the etiology and can rule out differential diagnosis. Differential diagnoses such as common peroneal nerve entrapment and chronic exertional compartment syndrome need to be ruled out 2. The diagnosis including the location of compression might be suspected on clinical grounds and can be confirmed by electrodiagnostic testing such as nerve conduction studies or electromyography 2 or by a diagnostic local nerve block 1. foot deformities high longitudinal plantar arch or tarsal coalition.too tight footwear, immobilization under the metal bar.The following sports and activities have an increased risk for the development of deep peroneal nerve entrapment 1,2: Deep peroneal nerve entrapment might be seen in athletes and people wearing tight shoes 1-3. ![]()
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