Fractures and dislocations: Baxter nerve entrapment: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Fractures and dislocations: Baxter nerve entrapment

Sample item

A 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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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is 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.

Why is "Sural nerve" not the answer?

The sural nerve runs on the lateral border of the foot and is unrelated to the medial heel.

Why is "Medial plantar nerve" not the answer?

The medial plantar nerve is compressed at the knot of Henry and causes jogger's foot with arch pain.

Why is "Medial calcaneal branch of the tibial nerve" not the answer?

The medial calcaneal branch is purely sensory to the heel pad and would not cause muscle wasting.

What concept does this question test?

It tests Fractures and dislocations: Baxter nerve entrapment in Orthopaedics. 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.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Fractures and dislocations: Baxter nerve entrapment?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.