International Journal of Anatomy and Research



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Type of Article: Original Research

Year: 2016 | Volume 4 | Issue 1 | Page No. 2034-2036

Date of Publication: 29-02-2016

DOI: http://dx.doi.org/10.16965/ijar.2016.139


A STUDY OF TIBIAL NERVE BIFURCATION AND BRANCHING PATTERN OF CALCANEAL NERVE IN THE TARSAL TUNNEL

D.Malar *.

* Assistant Professor, JSS Medical College, JSS University, Mysore, Karnataka,India.

Address: Dr. D. Malar, Assistant professor, JSS Medical College, JSS University, Mysore, Karnataka, India. Phone Number: 91-9448434067, 08212410142
E-Mail: janavi.rk@gmail.com, malarjan2519@gmail.com

Abstract

Background: Tibial nerve in the distal part of the leg branches into the calcaneal branch, medial plantar nerve and lateral plantat nerve.These branches inervate calcaneal,the medialplantar and the lateral plantar areas of the foot, respectively and carry sensory information from these areas.  Tibial nerve and its branches show variation in branching pattern, and level of bifurcation. Detail knowledge of the anatomical variation of tibial nerve and its branches is essential for diagnosis and therapy tarsal tunnel syndrome, fractures requiring external nailing and nerve blocks.
Materials and Methods: Tibial nerve and its branches in the tarsal tunnel were dissected and studiedl in twenty adult cadavers.  Bifurcation levels of tibial nerve in relation to the Medio-malleolar-calcaneal axis were noted. The ramification pattern of medial calcaneal nerve was observed and studied.
Results: In the present study tibial nerve bifurcation occurred within the tunnel in 100% cases. According to the level of bifurcation, 85% cases was type I, 10% cases was type II and 5%cases was type III. Medial calcaneal branches showed variations in number and origin, one medial calcaneal nerve was observed in 50% case , two in 20% cases and three in 10% of cases. The  medial calcaneal nerve originated from the tibial nerve in85% cases.
Conclusion: The knowledge of these variations may help in diagnosis and therapy of tarsal tunnel syndrome and prevent damage to the structures in the tarsal tunnel during various surgical procedures in the tarsal region.
Key words: Ttibial nerve, branches, variations , tarsal tunnel syndrome.

References

  1. Williams PL, Bannster LH, Martin, Berry, et al. Nervous system. Grey’s Anatomy.38th edn. London: Churchill living stone, 1996;1284-1286.
  2. Data AK. Posterior crural region.Essentials of human anatomy part III, 3rd edn.Kolkata: Current books international, 2004;204.
  3. Kohno M, Takahashi H, Segawa H, Sano K. Neurovascular decompression for idiopathic tarsal tunnel syndrome : technical note. J Neurol Neurosurg Psychiatry, 2000;69:87-90.
  4. Standing S, Ellis H, Healy JC, Jhonson D, William A et al. The Anatomical basis of clinical practice. Gray’s Anatomy, 39th edn London: Churchill Livingstone, 2005;1502-1504.
  5. Torres ALG, Ferreira MC. Study of anatomy of tibial nerve and its branches in the distal medial leg. Acta Ortopedica Brasileria. 2012;20(3):157- 164.
  6. Nagaoka M. An anatomical study of tarsal tunnel. Nippon  seikeigeka Gakkai Zasshi, 1910;64(4):208-216.
  7. Joshi SS, Joshi SD, Athavale SA. Anatomy of Tarsal tunnel and its applied significance. J.Anat.Soc. India, 2006;55(1):52-56.
  8. Davis TJ, Schon LC. Branches of the tibial nerve: anatomic variations. Foot Ankle Int.1995; 41(6):645-646.
  9. Ndiaye A, Dia A, Konate I, Diop M, Sow ML. Topographic  anatomy of the tibial nerve in the medial malleolus: application to the effect of nerve block anesthesia. Morphologie, 2003;87(277):25-27.
  10. Heimkes B, Posel P, Stotz S, Wolf K. The Proximal and distal tarsal tunnel syndromes. An Anatomical study. Int Orthop. 1987; 11(3):193-196.
  11. Bilge O, ozer MA, Govsa F. Neurovascular branching in the tarsal tunnel. Neuroanatomy, 2003;2:39-41.
  12. Andreasen Struijk LNS, Birn H, Teglbjaeg PS, Haase J, Stuijk JJ. Size and separability of the calcaneal and the medial and lateral plantar nerves in the distal tibial nerve. Anat. Sci. Int . 2010; 85:13-22.

 

D.Malar. A STUDY OF TIBIAL NERVE BIFURCATION AND BRANCHING PATTERN OF CALCANEAL NERVE IN THE TARSAL TUNNEL. Int J Anat Res 2016;4(1):2034-2036. DOI: 10.16965/ijar.2016.139

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