Marching neuropathy of the nervus digitalis plantaris proprii medialis halluci among military personnel

Abstract

Background. Marcher’s digitalgia paresthetica is a neuropathy of the medial plantar proper digital nerve (nervus digita lis plantaris proprii medialis halluci) and in some cases is accompanied by the formation of Joplin’s neuroma. Despite the general population rarity, marcher’s digitalgia paresthetica is significantly common among the special military contingent, athletes and tourists.Aim. To assess the prevalence of medial digital nerve neuropathy among military personnel and to identify possible factors contributing to its development.Materials and methods. The study involved 125 male servicemen of the Russian Federation, with an average age 37 (37–40) years. A neurological examination was performed with a detailed assessment of sensory disorders in the lower extremities, electroneuromyography and ultrasound examination of the leg nerves.Results. In 83 cases, or 66 (55–76) %, of digitalgia paresthetica were identified. Among them asymptomatic – 51 people, or 61 (47–74) %. In 27 cases – 33 (21–47) % – violation of sensitivity was observed on one side. The maximum area of violation of the sensitivity of the innervation of the medial‑plantar surface of the big toes was determined in 57 cases – 68 (55–80) %. At the same time, in 14 (6–25) % of the examined, the distal part of the second toe was additionally involved.Conclusion. In our study, the hypothesis about the influence of the type of footwear, the average daily duration of wearing and the frequency of its forced removal on the likelihood of developing paresthetic digitalgia was not confirmed. It is important that doctors are informed about the possible development of this neuropathy and its benign course.

Keywords

• marching neuropathy
• plantar nerve
• foot
• nerve entrapment neuropathies