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Accurate Nomenclature for Forefoot Nerve Entrapment

A Historical Perspective

Ethan E. Larson, MD ^*, Stephen L. Barrett, DPM , Bruno Battiston, MD , Christopher T. Maloney, Jr, MD   and A. Lee Dellon, MD   ^||

^* University of Arizona School of Medicine, Tucson.
Institute for Peripheral Nerve Surgery: Southwest, Tucson, AZ. Dr. Barrett is now at the Midwestern University College of Health Sciences, Glendale, AZ.
Microsurgery Unit, Department of Orthopedic Surgery, University of Turin, Turin, Italy.
Division of Plastic Surgery and Neurosurgery, Departments of Surgery and Anatomy, University of Arizona, Tucson.
^|| Division of Plastic Surgery, Department of Neurosurgery, The Johns Hopkins University, Baltimore, MD.

Corresponding author: A. Lee Dellon, MD, 3333 N Calvert St, Ste 370, Baltimore, MD 21218.

Abstract

Current medical nomenclature is often based on the early history of the condition, when the true etiology of the disease or condition was not known. Sadly, this incorrect terminology can become inextricably woven into the lexicon of mainstream medicine. More important, when this is the case, the terminology itself can become integrated into current clinical decision making and ultimately into surgical intervention for the condition. "Morton’s neuroma" is perhaps the most striking example of this nomenclature problem in foot and ankle surgery. We aimed to delineate the historical impetus for the terminology still being used today for this condition and to suggest appropriate terminology based on our current understanding of its pathogenesis. We concluded that this symptom complex should be given the diagnosis of nerve compression and be further distinguished by naming the involved nerve, such as compression of the interdigital nerve to the third web space or compression of the third common plantar digital nerve. Although the nomenclature becomes longer, the pathogenesis is correct, and treatment decisions can be made accordingly. (J Am Podiatr Med Assoc 95(3): 298–306, 2005)

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