Tibial nerve branching in the tarsal tunnel.
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 .Acta Ortopédica Brasileira 01/2012; 20(3):157-64. · 0.16 Impact Factor
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ABSTRACT: Introduction Entrapment of the medial heel region nerves is often mentioned as a possible cause of heel pain. Some authors have suggested that the medial calcaneal nerve (MCN) may be involved in such heel pain. The aim of the present study is to describe the variations of the origin of the medial calcaneal nerve and its branching patterns in the medial aspect of the calcaneus which establishes an anatomical guide for diagnosis and therapy of some tarsal region diseases. Material and methods The formation and course of the MCN were traced to its branches in the distal ankle with the use of 4.8 X stereomicroscope (Carl-Zeis) or 28 X loop magnification for dissections of 36 newborn feet of formalin fixed cadavers. Results The MCN originated from the tibial nerve (TN) in 61.1% and from the lateral plantar nerve (LPN) 16.7%, bilaterally. It branches from the TN on the right side and from the LPN on the left side in 11.1%, from the LPN on the right side and from the TN on the left side in 11.1%.The MCN consisted of 1 terminal branch in 3 out of 36 feet, 2 terminal branches in 28 out of 36, and 3 terminal branches in 5 out of 36. Discussion The course and the origin of MCN on the medial aspect of the heel and its terminal branches were quite different. These variabilities will enable the surgeon to find and preserve the MCN and its terminal branches.Journal of the Anatomical Society of India 09/2014; · 0.06 Impact Factor
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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.