The plantar areas of the foot have specific biomechanical characteristics and play a distinct role in balance and standing.
For the forefoot surgeon, knowledge of the variations in the anatomy of communicating branches is important for plantar reconstruction,
local injection therapy and an excision of interdigital neuroma. The anatomy of the communicating branches of the plantar
nerves between the fourth and third common plantar digital nerves in the foot were studied in 50 adult men cadaveric feet.
A communicating branch was present between the third and fourth intermetatarsal spaces nerves in all eight left feet and in
six right feet (overall, 28%), and absent in 36 (72%). A communicating branch was found in 14 ft. Ten of the 14 communications
were from the lateral to the medial plantar nerve. The length of the communicating branch ranged from 8 to 56 mm (average
16.4 mm) and its diameter was 0.2–0.6 times of the fourth common plantar digital nerve. The angle of the communicating branch
with the common plantar digital nerve from which it originated was less than 30° in 11 ft, 30–59° in 27 ft, 60–80° in 8 ft,
and more than 80° in 4 ft. Classification of the branch is based on the branching pattern of the communicating branch and
explains variations in plantar sensory innervations. We think that the perpendicular coursing communicating branch is at higher
risk to be severed during surgery.
Keywords Lateral plantar nerve - Medial plantar nerve - Communicating branch