Branching Patterns of Medial and Inferior Calcaneal Nerves Around the Tarsal Tunnel
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Objective To demonstrate the bifurcation pattern of the tibial nerve and its branches.Methods Eleven legs of seven fresh cadavers were dissected. The reference line for the bifurcation point of tibial nerve branches was an imaginary horizontal line passing the tip of the medial malleolus. The distances between the reference line and the bifurcation points were measured. The bifurcation branching patterns were categorized as type I, the pattern in which the medial calcaneal nerve (MCN) branched most proximally; type II, the pattern in which the three branches occurred at the same point; and type III, in which MCN branched most distally.Results There were seven cases (64%) of type I, three cases (27%) of type III, and one case (9%) of type II. The median MCN branching point was 0.2 cm (range, –1 to 3 cm). The median bifurcation points of the lateral plantar nerves and inferior calcaneal nerves was -0.6 cm (range, –1.5 to 1 cm) and –2.5 cm (range, –3.5 to –1 cm), respectively. Conclusion MCN originated from the tibial nerve in most cases, and plantar nerves were bifurcated below the medial malleolus. In all cases, inferior calcaneal nerves originated from the lateral plantar nerve. These anatomical findings could be useful for performing procedures, such as nerve block or electrophysiologic studies.
Abstract
Objective To demonstrate the bifurcation pattern of the tibial nerve and its branches.Methods Eleven legs of seven fresh cadavers were dissected. The reference line for the bifurcation point of tibial nerve branches was an imaginary horizontal line passing the tip of the medial malleolus. The distances between the reference line and the bifurcation points were measured. The bifurcation branching patterns were categorized as type I, the pattern in which the medial calcaneal nerve (MCN) branched most proximally; type II, the pattern in which the three branches occurred at the same point; and type III, in which MCN branched most distally.Results There were seven cases (64%) of type I, three cases (27%) of type III, and one case (9%) of type II. The median MCN branching point was 0.2 cm (range, –1 to 3 cm). The median bifurcation points of the lateral plantar nerves and inferior calcaneal nerves was -0.6 cm (range, –1.5 to 1 cm) and –2.5 cm (range, –3.5 to –1 cm), respectively. Conclusion MCN originated from the tibial nerve in most cases, and plantar nerves were bifurcated below the medial malleolus. In all cases, inferior calcaneal nerves originated from the lateral plantar nerve. These anatomical findings could be useful for performing procedures, such as nerve block or electrophysiologic studies.
참고문헌 (14)
- Williams PL, "Gray’s anatomy: the anatomical basis of medicine and surgery" (1995), Saunders
- Moore KL, "Clinically oriented anatomy" (1999), Lippincott Williams & Wilkins
- Draves DJ., "Anatomy of the lower extremity" (1986), Williams & Wilkins
- Ellis H., "Clinical anatomy" (1992), Blackwell Scientific Publications
- Gardner ED, "Anatomy: a regional study of human structure" (1969), Saunders
- Bareither DJ, "Variation in the division of the tibial nerve: application to nerve blocks", J Foot Surg, 29, pp.581~583 (1990)
- Thapa D, "Combination of diagnostic medial calcaneal nerve block followed by pulsed radiofrequency for plantar fascitis pain: a new modality", Indian J Anaesth, 58, pp.183~185 (2014)
- Martin-Oliva X, "Anatomical variants of the medial calcaneal nerve and the Baxter nerve in the tarsal tunnel", Acta Ortop Mex, 27, pp.38~42 (2013)
- Santi MD, "External fixation of the calcaneus and talus: an anatomical study for safe pin insertion", J Orthop Trauma, 10, pp.487~491 (1996)
- Casey D, "Percutaneous pin placement in the medial calcaneus: is anywhere safe?", J Orthop Trauma, 16, pp.26~29 (2002)
- Mekhail AO, "Anatomic considerations for safe placement of calcaneal pins", Clin Orthop Relat Res, 332, pp.254~259 (1996)
- Greene DL, "Anatomic study of the medial neurovascular structures in relation to calcaneal osteotomy", Foot Ankle Int, 22, pp.569~571 (2001)
- Horwitz MT., "Normal anatomy and variations of the peripheral nerves of the leg and foot", Arch Surg, 36, pp.626~636 (1938)
- Dellon AL, "Tibial nerve branching in the tarsal tunnel", Arch Neurol, 41, pp.645~646 (1984)