Tibial nerve: anatomic variations of the medial calcaneal branch

Abstract

Objective: This study is about the tibial nerve and its branches, inside the tarsal tunnel. The origin, number and position of the branches are described. These anatomic variations are compared with the normal pattern pointed in the current literature. Methods: One hundred sixty-four cadaveric feet, adults, were dissected and photographed. Results: The medial calcaneal nerve arises directly from the tibial nerve in 121 feet (73.8%). It was observed that the number of branches varied from one to four, but one or two were most frequent (95%). The site of origin showed that at least one branch emerges before the tunnel entrance in 91 feet (55%). Conclusions: The incidence of anatomic variations does not permit to define only one normal finding, based on anatomical textbooks descriptions. Clinical relevance: This anatomic research had the purpose to guide the surgeon when approaching the different etiologies of the tarsal syndrome.