Method: From July, 2001 to June, 2002, twelve patients who had calcaneal fractures with persistent foot pain and paresthesia were included in our study. We examined electromyography for medial and lateral plantar nerve, inferior calcaneal nerve, also evaluated types of calcaneal fracture and severity of pain and disability with nerve injury.

Results: The intraarticular types were 13 cases, extraarticular type was 1 case and communited types were 2 cases. In the electromyographic findings, the 9 cases were diagnosed as neuropathy. In a cases with neuropathy, 8 persons complained over moderate degree of pain and all persons complained over moderate degree of walking disability. However one of three persons without neuropathy complained over moderate degree of walking disability. So disability tended to be more severe in cases with neuropathy.

Conclusion: We think that neuropathy associated with calcaneal fracture is a cause of aggravation of pain and walking disability, and electromyography for nerves of foot will be needed in the calcaneal fracture. (J Korean Acad Rehab Med 2003; 27: 928-934)

Objective: To determine the reference values for the diagnosis of isolated entrapment neuropathies of medial and lateral plantar nerve and inferior calcaneal nerve distal to the tarsal tunnel.

Method: The subjects were neurologically healthy 30 adults (15 males, 15 females). Distal motor nerve conduction study of medial and lateral plantar nerves and inferior calcaneal nerve was performed. The recording muscles for medial and lateral plantar nerves and inferior calcaneal nerve were flexor hallucis brevis, flexor digiti minimi brevis, and abductor digiti minimi pedis, respectively. The stimulation was done at distal and proximal to the tarsal tunnel to differentiate the tarsal tunnel syndrome and the entrapment neuropathy of distal to the tarsal tunnel. The distance of recording and distal stimulation site was fixed to 10 cm for medial and lateral plantar nerves. The skin temperature was maintained 33^oC or above. The proximal latency, distal latency, peak to peak amplitude, conduction velocity and residual latency were measured. The reference values were obtained by 95 percentile values.

Results: The reference values for the diagnosis of isolated entrapment neuropathies of medial plantar nerve, lateral plantar nerve and inferior calcaneal nerve distal to tarsal tunnel are as follows.

1) Medial plantar nerve: distal latency, ＞ 4.3 msec; side to side difference, ＞ 0.7 msec

2) Lateral plantar nerve: distal latency, ＞ 4.1 msec; side to side difference, ＞ 0.6 msec

3) Latency difference of medial and lateral plantar nerve: ＞ 0.7 msec

4) Inferior calcaneal nerve: distal latency, ＞ 4.3 msec; distal peak latency, ＞ 7.2 msec; side to side difference of distal onset latency, ＞ 1.5 msec; side to side difference of distal peak latency, ＞ 0.8 msec; residual latency, ＞ 3.0 msec

Conclusion: The distal motor nerve conduction method used in this study and the reference values could be used to differentiate entrapment neuropathies of medial and lateral plantar nerve and inferior calcaneal nerve distal to the tarsal tunnel from tarsal tunnel syndrome.