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Lower-Extremity Sclerotomes

Clinical Applications and the Modified Mayo Block

Andrew J. Meyr, DPM ^* and Raymond DiPrimio, DPM 

^* Department of Orthopedics, INOVA Fairfax Hospital, Falls Church, VA.
Department of Anatomy, Temple University School of Podiatric Medicine, Philadelphia, PA.

Corresponding author: Andrew J. Meyr, DPM, Department of Orthopedics, INOVA Fairfax Hospital, Podiatric Surgery Residency Office, 3300 Gallows Rd, Falls Church, VA 22042. (E-mail: ajmeyr{at}gmail.com)

Abstract

A sclerotome is an anatomical concept that defines an area of bone supplied by a single spinal nerve. Similar to the familiar dermatomes, sclerotomes provide an element of depth to the sensory innervation of the lower extremity based on the deep fascia as an embryologic boundary. Anatomical knowledge of sclerotomes can be used clinically in the diagnosis and treatment of pain and in the perioperative setting. Specifically, a modified version of the classic Mayo block is presented to highlight an active anatomical approach to peripheral nerve blockade. (J Am Podiatr Med Assoc 99(3): 232–235, 2009)