Higher division of the tibial nerve in the leg

Gross anatomical study with clinical implications

Research output: Contribution to journalArticle

Abstract

Background and Objectives. Tibial nerve is a branch of the sciatic nerve and it is the main nerve innervating the muscles of the back of the leg. The tibial nerve divides into medial and lateral plantar nerves. The level of division may be important for surgical purpose. The main aim of the present study was to observe the exact level of division of the tibial nerve and discuss its clinical implications. Materials and Methods. A total of 20 cadaveric limbs (irrespective of left or right side) were taken randomly. The posterior compartment of the thigh and leg was dissected to trace the tibial nerve and its branches. The specimens were subjected to measurements with respect to an arbitrary horizontal line passing through tip of medial malleolus and the calcaneum. All the specimens were photographed. Results. In 5 cases (25%), the tibial nerve divided deep to the flexor retinaculum. In 15 cases (75%) cases, the tibial nerve divided at a distance of 3.5 cm - 6.5 cm (average 5 cm) above the medial malleolus. Conclusion. The tibial nerve and its divisions are important for performing successful nerve blocks and insertion of plates while treating fractures. Variations may account for the various discrepancies between the electromyographic tests and clinical tests.

Original languageEnglish
Pages (from-to)1-3
Number of pages3
JournalClinica Terapeutica
Volume164
Issue number1
DOIs
Publication statusPublished - 2013

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Tibial Nerve
Leg
Back Muscles
Clinical Studies
Nerve Block
Sciatic Nerve
Thigh
Extremities

Keywords

  • Anatomy
  • Anomaly
  • Branch
  • Leg
  • Nerve
  • Tibial
  • Variation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Higher division of the tibial nerve in the leg: Gross anatomical study with clinical implications",
abstract = "Background and Objectives. Tibial nerve is a branch of the sciatic nerve and it is the main nerve innervating the muscles of the back of the leg. The tibial nerve divides into medial and lateral plantar nerves. The level of division may be important for surgical purpose. The main aim of the present study was to observe the exact level of division of the tibial nerve and discuss its clinical implications. Materials and Methods. A total of 20 cadaveric limbs (irrespective of left or right side) were taken randomly. The posterior compartment of the thigh and leg was dissected to trace the tibial nerve and its branches. The specimens were subjected to measurements with respect to an arbitrary horizontal line passing through tip of medial malleolus and the calcaneum. All the specimens were photographed. Results. In 5 cases (25{\%}), the tibial nerve divided deep to the flexor retinaculum. In 15 cases (75{\%}) cases, the tibial nerve divided at a distance of 3.5 cm - 6.5 cm (average 5 cm) above the medial malleolus. Conclusion. The tibial nerve and its divisions are important for performing successful nerve blocks and insertion of plates while treating fractures. Variations may account for the various discrepancies between the electromyographic tests and clinical tests.",
keywords = "Anatomy, Anomaly, Branch, Leg, Nerve, Tibial, Variation",
author = "{Abd. Ghafar}, Norzana and Farihah Suhaimi and Fairus Ahmad and Teoh, {Seong Lin} and Nur, {A. K.} and Faizah Othman and Srijit Das",
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AU - Abd. Ghafar, Norzana

AU - Suhaimi, Farihah

AU - Ahmad, Fairus

AU - Teoh, Seong Lin

AU - Nur, A. K.

AU - Othman, Faizah

AU - Das, Srijit

PY - 2013

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N2 - Background and Objectives. Tibial nerve is a branch of the sciatic nerve and it is the main nerve innervating the muscles of the back of the leg. The tibial nerve divides into medial and lateral plantar nerves. The level of division may be important for surgical purpose. The main aim of the present study was to observe the exact level of division of the tibial nerve and discuss its clinical implications. Materials and Methods. A total of 20 cadaveric limbs (irrespective of left or right side) were taken randomly. The posterior compartment of the thigh and leg was dissected to trace the tibial nerve and its branches. The specimens were subjected to measurements with respect to an arbitrary horizontal line passing through tip of medial malleolus and the calcaneum. All the specimens were photographed. Results. In 5 cases (25%), the tibial nerve divided deep to the flexor retinaculum. In 15 cases (75%) cases, the tibial nerve divided at a distance of 3.5 cm - 6.5 cm (average 5 cm) above the medial malleolus. Conclusion. The tibial nerve and its divisions are important for performing successful nerve blocks and insertion of plates while treating fractures. Variations may account for the various discrepancies between the electromyographic tests and clinical tests.

AB - Background and Objectives. Tibial nerve is a branch of the sciatic nerve and it is the main nerve innervating the muscles of the back of the leg. The tibial nerve divides into medial and lateral plantar nerves. The level of division may be important for surgical purpose. The main aim of the present study was to observe the exact level of division of the tibial nerve and discuss its clinical implications. Materials and Methods. A total of 20 cadaveric limbs (irrespective of left or right side) were taken randomly. The posterior compartment of the thigh and leg was dissected to trace the tibial nerve and its branches. The specimens were subjected to measurements with respect to an arbitrary horizontal line passing through tip of medial malleolus and the calcaneum. All the specimens were photographed. Results. In 5 cases (25%), the tibial nerve divided deep to the flexor retinaculum. In 15 cases (75%) cases, the tibial nerve divided at a distance of 3.5 cm - 6.5 cm (average 5 cm) above the medial malleolus. Conclusion. The tibial nerve and its divisions are important for performing successful nerve blocks and insertion of plates while treating fractures. Variations may account for the various discrepancies between the electromyographic tests and clinical tests.

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