title: Tibial nerve branching in the tarsal tunnel.
abstract: Tarsal tunnel syndrome is an infrequent and probably underdiagnosed clinical condition. Diagnosis and treatment depend on understanding the tibial branching pattern within the tarsal tunnel. A total of 68 foot dissections were performed. Bifurcation into the medial and lateral plantar nerves occurred within the tunnel in 93% and proximal in 7%. Proximal bifurcation may predispose to tarsal tunnel syndrome, and its infrequent occurrence correlates with the infrequent clinical diagnosis. Nine different calcaneal branching patterns were noted; they provide an anatomical explanation for heel sparing. An understanding of anatomic variations should aid in providing complete surgical release and in avoiding accidental heel denervations.
authors.affiliation: Medical College of Ohio, Department of Orthopaedic Surgery, Toledo 43699.
authors.forename: P E
authors.initials: PE
authors.lastname: Havel
authors.forename: N A
authors.initials: NA
authors.lastname: Ebraheim
authors.forename: S E
authors.initials: SE
authors.lastname: Clark
authors.forename: W T
authors.initials: WT
authors.lastname: Jackson
authors.forename: L
authors.initials: L
authors.lastname: DiDio
mesh_terms: D000842:Ankle / Q000294:innervation*; D002102:Cadaver; D002111:Calcaneus / Q000294:innervation*; D006801:Humans; D010523:Peripheral Nervous System Diseases / Q000473:pathology* / Q000503:physiopathology; D013641:Tarsal Tunnel Syndrome / Q000473:pathology* / Q000503:physiopathology; D013979:Tibial Nerve / Q000033:anatomy & histology / Q000473:pathology* / Q000503:physiopathology