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Novel, user-friendly landmarks for localizing Baxter's nerve: A cadaveric study.

Inah Kim1, Kyung Eun Nam1, Minsuk Kang1

  • 1Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Clinical Anatomy (New York, N.Y.)
|February 22, 2021
PubMed
Summary

New anatomical landmarks improve ultrasonography for Baxter's nerve (BN) identification. This study offers user-friendly guides for precise localization of BN entrapment sites, aiding practitioners.

Keywords:
Baxter nervecadaverimpingementlateral plantar nerveultrasonography

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Area of Science:

  • Anatomy
  • Medical Imaging
  • Podiatry

Background:

  • Baxter's nerve (BN) identification via ultrasonography is difficult for less experienced practitioners due to insufficient landmarks.
  • Accurate localization of BN is crucial for diagnosing and treating related foot conditions.

Purpose of the Study:

  • To establish novel, user-friendly anatomical landmarks for ultrasonographic localization of Baxter's nerve.
  • To identify key structures for precise localization of the BN entrapment site.

Main Methods:

  • Examined 24 fresh cadaveric feet to identify landmarks and the BN entry point into the quadratus plantae (QP) muscle.
  • Utilized a rectangular coordinate system with defined points (P, Q, B) and ratios (X, Y) normalized to foot size.

Main Results:

  • Landmarks P (medial malleolus) and Q (navicular tuberosity) showed better interobserver agreement than B (calcaneus center).
  • Ratios X and Y for the QP were 61.25% and 99.80%, respectively.
  • Baxter's nerve originated from the lateral plantar nerve in 83% of specimens, with adjacent vessels <3mm from the entrapment site in 83%.

Conclusions:

  • The newly established landmarks enhance the precision of localizing Baxter's nerve entrapment sites.
  • These findings provide improved guidelines for podiatric practitioners using ultrasonography.