Article

Tibial nerve branching in the tarsal tunnel.

JAMA Neurology (Impact Factor: 7.01). 07/1984; 41(6):645-6. DOI: 10.1001/archneur.1984.04210080053013
Source: PubMed

ABSTRACT To provide an anatomical basis for diagnosis and treatment of the tarsal tunnel syndrome, the relationship of the tibial nerve to the tarsal tunnel was investigated in 31 feet of 20 cadavers. The bifurcation into medial and lateral plantar nerves occurred within 1 cm of the malleolar-calcaneal axis in 90% of the feet. Seven of 11 bilateral specimens were bilaterally symmetrical in the bifurcation location; three varied within 1 cm between sides; and in the fourth cadaver, one side bifurcated at 3 cm and the other at 5 cm proximal to the axis. The calcaneal nerve showed great variability; in seven cadavers, it arose within, in eight cadavers proximal to, and in five cadavers there were multiple branches arising both proximal to and within the tarsal tunnel.

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    ABSTRACT: Determine, through dissection in fresh cadavers, the topographic anatomy of the tibial nerve and its branches at the ankle, in relation to the tarsal tunnel. Bilateral dissections were performed on 26 fresh cadavers and the locations of the tibial nerve bifurcation and its branches were measured in millimeters. For the calcaneal branches, the amount and their respective nerves of origin were also analyzed. The tibial nerve bifurcation occurred under the tunnel in 88% of the cases and proximally in 12%. As for the calcaneal branches, the medial presented with one (58%), two (34%) and three (8%) branches, with the most common source occurring in the tibial nerve (90%) and the lower with a single branch per leg and lateral plantar nerve as the most common origin (70%). Level of Evidence, V Expert opinion .
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    ABSTRACT: Objective : Tarsal tunnel syndrome is a rare compressive neuropathy. In Korea, the reported cases of the tarsal tunnel syndrome are mainly related to diagnosis, so there are only a few reports about the surgical result. We report the significance of the decompressive surgery for the tarsal tunnel syndrome. Methods : Seven patients with tarsal tunnel syndrome were treated surgically. The patients were aged 31-70 years (mean 53.1 years), and all of them complained of pain or dysesthesia of the sole of the foot. The posterior tibial nerve and its branches were decompressed through the flexor retinaculum and under the abductor hallucis muscle fascia. Results : Surgical decompression was beneficial in most patients with tarsal tunnel syndrome in their feet. Neither wound infection nor recurrence of symptoms was found during the follow up period (mean 12.9 months). Conclusion : Surgical decompression is the good option for the treatment of the tarsal tunnel syndrome, especially in the cases of short symptom duration or mass lesion.