Related Experiment Video
Updated: Jan 21, 2026

Laparoscopic Anatomical Resection of the Right Anterior Lobe Based on the Laennec Capsule Technique
Published on: May 2, 2025
An Anatomic and Clinical Study of the Innervation of the Dorsal Midfoot Capsule
Glenn G Shi1, Meredith A Williams1, Joseph L Whalen1
1Department of Orthopedic Surgery, Mayo Clinic Florida, Jacksonville, FL, USA.
Background:
Dorsal pain from osteoarthritic midfoot joints is thought to be relayed by branches of the medial and lateral plantar, sural, saphenous, and deep peroneal nerves (DPN). However, there is no consensus on the actual number or pathways of the nervous branches for midfoot joint capsular innervation. This study examined the DPN's terminal branches at the midfoot joint capsules through anatomic dissection and confirmation of their significance in a clinical case series of patients with midfoot pain relief after DPN block.
Methods:
Eleven cadaveric lower leg specimens, 6 left and 5 right, were dissected using operative loupe magnification. We preserved the terminal branches and recorded their paths and branching patterns. Joint capsular innervations were individually noted. To confirm our hypothesis of significant dorsal midfoot joint capsular innervation by the DPN, we also performed an institutional review board-approved retrospective chart review of 37 patients with painful dorsal midfoot osteoarthritis who underwent diagnostic local anesthetic injection block of the DPN. The percentage of temporary pain relief after the injection was recorded.
Results:
Terminal innervation of the DPN branches showed distribution of the second and third tarsometatarsal joints in all specimens. Inconsistent innervation of the naviculocuneiform (9/11), fourth (7/11), first (6/11), and fifth (4/11) tarsometatarsal and calcaneocuboid joints (1/11) were observed. The retrospective review of pain relief in patients with dorsal midfoot pain due to arthritis after diagnostic injection demonstrated a mean of 92.1% improvement.
Conclusion:
Innervation of the dorsal midfoot joint capsule appears to follow a consistent distribution across 3 joints: second and third tarsometatarsal joints and the naviculocuneiform joint. Acute relief of dorsal midfoot arthritic pain after diagnostic injection suggests that dorsal midfoot nociceptive pain is at least partly transmitted by the DPN.
Level Of Evidence:
Level IV, case series.
Related Concept Videos
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Anatomical Positions
The body is upright, facing forward, and standing erect.
The feet are parallel and flat on the floor.
The arms are hanging by the...
Anatomical Terminology
Anatomical Movements
Here are some common anatomical movements:
Flexion and extension motions are in the sagittal (anterior–posterior) plane of motion. These movements take place at the shoulder, hip, elbow, knee, wrist,...
Hypertension III: Clinical Manifestations and Diagnostic Studies
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

