Anatomy of the tibial nerve in relation to the tarsal tunnel: A cadaveric study. Issue 8 (December 2022)

• Record Type: Journal Article
• Authors: Mattos, Ivan; Ubillus, Hugo A.; Campos, Gustavo; Soares, Sergio; Azam, Mohammad T.; Oliva, Xavier Martin; Kennedy, John G.
• Is Part Of: Foot and ankle surgery. Volume 28:Issue 8(2022)
• Page Start: 1415
• Page End: 1420
• Publication Date: 2022-12
• Subjects: Tarsal tunnel syndrome -- Tibial nerve -- Crural Fascia -- Malleolar-calcaneal line; Foot -- Surgery -- Periodicals; Ankle -- Surgery -- Periodicals; Ankle -- surgery -- Periodicals; Foot -- surgery -- Periodicals; Ankle -- Surgery; Foot -- Surgery; Periodicals; Electronic journals; 617.58
• DOI: 10.1016/j.fas.2022.07.011
• Languages: English
• ISSNs: 1268-7731

Abstract

Abstract: Background: Tarsal tunnel syndrome (TTS) is typically caused by an anatomical variant or mechanical compression of the tibial nerve (TN) with variable success after surgical treatment. Method: 40 lower-leg specimens were obtained. Dissections were appropriately conducted. Extremities were prepared under formaldehyde solution. The tibial nerve and branches were dissected for measurements and various characteristics. Results: The flexor retinaculum had a denser consistency in 22.5% of the cases and the average length was 51.9 mm. The flexor retinaculum as an independent structure was absent and 77.2% of cases as an undistinguished extension of the crural fascia. The lateral plantar nerve (LPN) and abductor digiti minimi (ADM) nerve shared same origin in 80% of cases, 34.5% bifurcated proximal to the DM (Dellon-McKinnon malleolar-calcaneal line) line 31.2% distally and 34.3% at the same level. Conclusion: Understanding the tibial nerve anatomy will allow us to adapt our surgical technique to improve the treatment of this recurrent pathology. Tarsal tunnel syndrome Tibial nerve Crural Fascia Malleolar-calcaneal line