24/08/2025
🦵 Tibial nerve origin and pathway
• Branches from the sciatic nerve slightly above the popliteal fossa
• Runs behind the knee
• Passes through the tarsal tunnel around the medial malleolus
🦶 Plantar nerve branching
• Branches to the medial and lateral plantar nerves around the tarsal tunnel
• Pe*****te into the fascia of the abductor hallucis muscle
• Run from the sole to the toes
• Innervate the sensory of the anterior part of the plantar
⚪ Medial calcaneal nerve
• Branches from the posterior tibial nerve at the proximal end of the tarsal tunnel
• Pierces the flexor retinaculum
• Innervates the sensory of the medial calcaneus
🏗️ Tarsal tunnel structure
• Composed of a rigid bone at the bottom
• Covered by the flexor retinaculum
📍 Structures passing through the tarsal tunnel
• Tibialis posterior tendon
• Flexor digitorum longus tendon
• Posterior tibial artery and veins
• Posterior tibial nerve
• Flexor hallucis longus tendon
🔗 Neurovascular relation
• Posterior tibial nerve runs with the posterior tibial artery and veins in the tarsal tunnel
⚠️ Clinical relevance
• Because of these anatomical features, the posterior tibial nerve may be damaged at the tarsal tunnel (tarsal tunnel syndrome: TTS)
• TTS was first reported by Keck and Lam in 1962 [1, 2]
