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An anatomical approach to the tarsal tunnel syndrome: what can ankle’s medial side anatomy reveal to us?
BACKGROUND: The heel is a complex anatomical region and is very often the source of pain complaints. The medial heel contains a number of structures, capable of compressing the main nerves of the region and knowing its anatomical topography is mandatory. The purpose of this work is to evaluate if ti...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644421/ https://www.ncbi.nlm.nih.gov/pubmed/37957735 http://dx.doi.org/10.1186/s13047-023-00682-4 |
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author | Lopes, Jorge Gomes Rodrigues-Pinho, André Neves, Maria Abreu Pinto, Filipe Fonseca Relvas-Silva, Miguel Vital, Luísa Serdoura, Francisco Nogueira-Sousa, António Madeira, Maria Dulce Pereira, Pedro Alberto |
author_facet | Lopes, Jorge Gomes Rodrigues-Pinho, André Neves, Maria Abreu Pinto, Filipe Fonseca Relvas-Silva, Miguel Vital, Luísa Serdoura, Francisco Nogueira-Sousa, António Madeira, Maria Dulce Pereira, Pedro Alberto |
author_sort | Lopes, Jorge Gomes |
collection | PubMed |
description | BACKGROUND: The heel is a complex anatomical region and is very often the source of pain complaints. The medial heel contains a number of structures, capable of compressing the main nerves of the region and knowing its anatomical topography is mandatory. The purpose of this work is to evaluate if tibial nerve (TN) and its main branches relate to the main anatomical landmarks of the ankle’s medial side and if so, do they have a regular path after emerging from TN. METHODS: The distal part of the legs, ankles and feet of 12 Thiel embalmed cadavers were dissected. The pattern of the branches of the TN was registered and the measurements were performed according to the Dellon–McKinnon malleolar-calcaneal line (DML) and the Heimkes Triangle (HT). RESULTS: The TN divided proximal to DML in 87.5%, on top of the DML in 12,5% and distal in none of the feet. The Baxter’s nerve (BN) originated proximally in 50%, on top of the DML in 12,5% and distally in 37.5% of the cases. There was a strong and significant correlation between the length of DML and the distance from the center of the medial malleolus (MM) to the lateral plantar nerve (LPN), medial plantar (MPN) nerve, BN and Medial Calcaneal Nerve (MCN) (ρ: 0.910, 0.866, 0.970 and 0.762 respectively, p < 0.001). CONCLUSIONS: In our sample the TN divides distal to DML in none of the cases. We also report a strong association between ankle size and the distribution of the MPN, LPN, BN and MCN. We hypothesize that location of these branches on the medial side of the ankle could be more predictable if we take into consideration the distance between the MM and the medial process of the calcaneal tuberosity. |
format | Online Article Text |
id | pubmed-10644421 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-106444212023-11-14 An anatomical approach to the tarsal tunnel syndrome: what can ankle’s medial side anatomy reveal to us? Lopes, Jorge Gomes Rodrigues-Pinho, André Neves, Maria Abreu Pinto, Filipe Fonseca Relvas-Silva, Miguel Vital, Luísa Serdoura, Francisco Nogueira-Sousa, António Madeira, Maria Dulce Pereira, Pedro Alberto J Foot Ankle Res Research BACKGROUND: The heel is a complex anatomical region and is very often the source of pain complaints. The medial heel contains a number of structures, capable of compressing the main nerves of the region and knowing its anatomical topography is mandatory. The purpose of this work is to evaluate if tibial nerve (TN) and its main branches relate to the main anatomical landmarks of the ankle’s medial side and if so, do they have a regular path after emerging from TN. METHODS: The distal part of the legs, ankles and feet of 12 Thiel embalmed cadavers were dissected. The pattern of the branches of the TN was registered and the measurements were performed according to the Dellon–McKinnon malleolar-calcaneal line (DML) and the Heimkes Triangle (HT). RESULTS: The TN divided proximal to DML in 87.5%, on top of the DML in 12,5% and distal in none of the feet. The Baxter’s nerve (BN) originated proximally in 50%, on top of the DML in 12,5% and distally in 37.5% of the cases. There was a strong and significant correlation between the length of DML and the distance from the center of the medial malleolus (MM) to the lateral plantar nerve (LPN), medial plantar (MPN) nerve, BN and Medial Calcaneal Nerve (MCN) (ρ: 0.910, 0.866, 0.970 and 0.762 respectively, p < 0.001). CONCLUSIONS: In our sample the TN divides distal to DML in none of the cases. We also report a strong association between ankle size and the distribution of the MPN, LPN, BN and MCN. We hypothesize that location of these branches on the medial side of the ankle could be more predictable if we take into consideration the distance between the MM and the medial process of the calcaneal tuberosity. BioMed Central 2023-11-14 /pmc/articles/PMC10644421/ /pubmed/37957735 http://dx.doi.org/10.1186/s13047-023-00682-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Lopes, Jorge Gomes Rodrigues-Pinho, André Neves, Maria Abreu Pinto, Filipe Fonseca Relvas-Silva, Miguel Vital, Luísa Serdoura, Francisco Nogueira-Sousa, António Madeira, Maria Dulce Pereira, Pedro Alberto An anatomical approach to the tarsal tunnel syndrome: what can ankle’s medial side anatomy reveal to us? |
title | An anatomical approach to the tarsal tunnel syndrome: what can ankle’s medial side anatomy reveal to us? |
title_full | An anatomical approach to the tarsal tunnel syndrome: what can ankle’s medial side anatomy reveal to us? |
title_fullStr | An anatomical approach to the tarsal tunnel syndrome: what can ankle’s medial side anatomy reveal to us? |
title_full_unstemmed | An anatomical approach to the tarsal tunnel syndrome: what can ankle’s medial side anatomy reveal to us? |
title_short | An anatomical approach to the tarsal tunnel syndrome: what can ankle’s medial side anatomy reveal to us? |
title_sort | anatomical approach to the tarsal tunnel syndrome: what can ankle’s medial side anatomy reveal to us? |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644421/ https://www.ncbi.nlm.nih.gov/pubmed/37957735 http://dx.doi.org/10.1186/s13047-023-00682-4 |
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