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Background: Dorsal pain from osteoarthritic midfoot joints is thought to be relayed by branches of the medial and lateral plantar, sural, saphenous, and deep peroneal nerves (DPN). However, there is no consensus on the actual number or pathways of the nervous branches for midfoot joint capsular innervation. This study examined the DPN’s terminal branches at the midfoot joint capsules through anatomic dissection and confirmation of their significance in a clinical case series of patients with midfoot pain relief after DPN block.Methods: Eleven cadaveric lower leg specimens, 6 left and 5 right, were dissected using operative loupe magnification. We preserved the terminal branches and recorded their paths and branching patterns. Joint capsular innervations were individually noted. To confirm our hypothesis of significant dorsal midfoot joint capsular innervation by the DPN, we also performed an institutional review board–approved retrospective chart review of 37 patients with painful dorsal midfoot osteoarthritis who underwent diagnostic local anesthetic injection block of the DPN. The percentage of temporary pain relief after the injection was recorded.Results: Terminal innervation of the DPN branches showed distribution of the second and third tarsometatarsal joints in all specimens. Inconsistent innervation of the naviculocuneiform (9/11), fourth (7/11), first (6/11), and fifth (4/11) tarsometatarsal and calcaneocuboid joints (1/11) were observed. The retrospective review of pain relief in patients with dorsal midfoot pain due to arthritis after diagnostic injection demonstrated a mean of 92.1% improvement.Conclusion: Innervation of the dorsal midfoot joint capsule appears to follow a consistent distribution across 3 joints: second and third tarsometatarsal joints and the naviculocuneiform joint. Acute relief of dorsal midfoot arthritic pain after diagnostic injection suggests that dorsal midfoot nociceptive pain is at least partly transmitted by the DPN.Level of Evidence: Level IV, case series.

Coastal sediment transport and associated morphological change can be examined at many spatial and temporal scales. These scales range from instantaneous movement of single grains on a time scale of the local turbulence to seasonal and long-term movement of large sand bodies such as longshore bars and tidal deltas. Researchers have begun to recognize that a first-principles (microscale) approach to calculating long-term and large-scale (megascale) coastal change may not be possible or even adequate. Therefore, new approaches are being sought to advance quantitative understanding and prediction of large-scale coastal behavior. The present paper opens with a discussion of compatible spatial and temporal scales for calculating sediment transport and morphology change. Motivation is given for the need to calculate morphologic change at scales greater than the typical one of microscale. Example calculations are made at different scales, showing the assumptions and approximations of each. The main conclusion is that calculations at different scales can be related and reconciled if limitations in prediction of initial and boundary conditions and in the fluid forcing are recognized.