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Original article
Published online: 2020-06-03
Submitted: 2020-04-04
Accepted: 2020-05-26
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Ultrasound guided topographic anatomy of the medial calcaneal branches of the tibial nerve

Ł. Warchol, J. A. Walocha, E. Mizia, M. Bonczar, H. Liszka, M. Koziej
DOI: 10.5603/FM.a2020.0062
·
Pubmed: 32488855

open access

Ahead of Print
ORIGINAL ARTICLES
Published online: 2020-06-03
Submitted: 2020-04-04
Accepted: 2020-05-26

Abstract

Background: The purpose of this study was to evaluate the topographic anatomy of the tibial nerve and its medial calcaneal branches in relation to the tip of the medial malleolus and to the posterior superior tip of the calcaneal tuberosity using the ultrasound examination and to verify its preoperative usefulness in surgical treatment.

Materials and methods: Bilateral ultrasound examination was  performed on 30 volunteers and the location of the tibial nerve bifurcation and medial calcaneal branches origin were measured. Medial calcaneal branches were analyzed in reference to the amount and their respective nerves of origin.

Results: In 77% cases tibial nerve bifurcation occurred below the tip of the medial malleolus with the average distance of 5.9 mm and in 48% cases above the attachment of the posterior superior tip of the calcaneal tuberosity with the average distance of 2.7 mm. In 73% cases medial calcaneal branches occurred as a single branch originating from the tibial nerve (60%). The average distance of the first, second and third medial calcaneal branch was accordingly 9.3 mm above, 9.5 mm below and 11.6 mm below the tip of the medial malleolus and 17.7 mm above, 1.6 mm below and 4 mm below the posterior superior tip of the calcaneal tuberosity.

Conclusions: As the tibial nerve and its branches presents a huge variability in the medial ankle area in order to prevent the iatrogenic injuries the preoperative or intraoperative ultrasound assessment (sonosurgery) of its localization should be introduced into the clinic.

Abstract

Background: The purpose of this study was to evaluate the topographic anatomy of the tibial nerve and its medial calcaneal branches in relation to the tip of the medial malleolus and to the posterior superior tip of the calcaneal tuberosity using the ultrasound examination and to verify its preoperative usefulness in surgical treatment.

Materials and methods: Bilateral ultrasound examination was  performed on 30 volunteers and the location of the tibial nerve bifurcation and medial calcaneal branches origin were measured. Medial calcaneal branches were analyzed in reference to the amount and their respective nerves of origin.

Results: In 77% cases tibial nerve bifurcation occurred below the tip of the medial malleolus with the average distance of 5.9 mm and in 48% cases above the attachment of the posterior superior tip of the calcaneal tuberosity with the average distance of 2.7 mm. In 73% cases medial calcaneal branches occurred as a single branch originating from the tibial nerve (60%). The average distance of the first, second and third medial calcaneal branch was accordingly 9.3 mm above, 9.5 mm below and 11.6 mm below the tip of the medial malleolus and 17.7 mm above, 1.6 mm below and 4 mm below the posterior superior tip of the calcaneal tuberosity.

Conclusions: As the tibial nerve and its branches presents a huge variability in the medial ankle area in order to prevent the iatrogenic injuries the preoperative or intraoperative ultrasound assessment (sonosurgery) of its localization should be introduced into the clinic.

Get Citation

Keywords

medial calcaneal nerve, ultrasound-guided nerve examination, tarsal tunnel syndrome, medial plantar nerve, lateral plantar nerve, sonosurgery

About this article
Title

Ultrasound guided topographic anatomy of the medial calcaneal branches of the tibial nerve

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Original article

Published online

2020-06-03

DOI

10.5603/FM.a2020.0062

Pubmed

32488855

Keywords

medial calcaneal nerve
ultrasound-guided nerve examination
tarsal tunnel syndrome
medial plantar nerve
lateral plantar nerve
sonosurgery

Authors

Ł. Warchol
J. A. Walocha
E. Mizia
M. Bonczar
H. Liszka
M. Koziej

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