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Orthopaedics · Fractures and dislocations: Baxter nerve entrapment
Sample itemA runner has chronic medial heel pain that has not improved with treatment for plantar fasciitis. Tenderness is maximal at the medial heel and there is wasting of abductor digiti minimi. Which nerve is entrapped between abductor hallucis and quadratus plantae?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. First branch of the lateral plantar nerve
Baxter nerve is the first branch of the lateral plantar nerve, also called the inferior calcaneal nerve. Compression between the deep fascia of abductor hallucis and the quadratus plantae causes chronic heel pain that mimics plantar fasciitis, and may atrophy abductor digiti minimi. It accounts for a proportion of resistant heel pain.
Option by option
A. First branch of the lateral plantar nerve (correct)
Correct. The inferior calcaneal branch of the lateral plantar nerve is trapped in this plane and supplies abductor digiti minimi.
B. Sural nerve
The sural nerve runs on the lateral border of the foot and is unrelated to the medial heel.
C. Medial plantar nerve
The medial plantar nerve is compressed at the knot of Henry and causes jogger's foot with arch pain.
D. Medial calcaneal branch of the tibial nerve
The medial calcaneal branch is purely sensory to the heel pad and would not cause muscle wasting.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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