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. 2012;20(3):157-64.
doi: 10.1590/S1413-78522012000300005.

Study of the anatomy of the tibial nerve and its branches in the distal medial leg

André Leal Gonçalves Torres  1 , Marcus Castro Ferreira  2
Affiliations

Study of the anatomy of the tibial nerve and its branches in the distal medial leg

André Leal Gonçalves Torres et al. Acta Ortop Bras. 2012.

Abstract

Objective: 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.

Methods: 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.

Results: 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 .

Keywords: Cadáver; Dissection; Peripheral nerves; Tarsal tunnel syndrome; Tibial nerve/anatomy & histology.

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Conflict of interest statement

All the authors declare that there is no potential conflict of interest referring to this article.

Figures

Figure 1
Figure 1
Elevated cutaneous and fascial flaps; dissection of the vascular bundle (reflected distally) and deinsertion of the abductor hallucis muscle.
Figure 2
Figure 2
Malleolar-calcaneal axis (MCA) and limits of the retinaculum.
Figure 3
Figure 3
Location of the tibial nerve bifurcations in relation to the MCA.
Figure 4
Figure 4
Example of type IV bifurcation.
Figure 5
Figure 5
Medial calcaneal branch – origin of the medial plantar nerve.
Figure 6
Figure 6
Medial calcaneal branch – origin of the lateral plantar nerve.
Figure 7
Figure 7
Medial calcaneal branch – origin 346.60mm proximal to the MCA.
Figure 8
Figure 8
Medial calcaneal branches: distances in relation to the MCA.
Figure 9
Figure 9
Distances of the emissions of the lower calcaneal branches in relation to the MCA.
Figure 10
Figure 10
Lower calcaneal branch – example of origin of the common trunk with the lateral plantar and the medial calcaneal.
See this image and copyright information in PMC

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