A Study of Tibial Nerve - Origin, Course and Motor Branching Pattern to Deep Muscles of the Posterior Leg
European Journal of Molecular & Clinical Medicine,
2021, Volume 8, Issue 4, Pages 2208-2214
AbstractBackground: Tibial nerve which is the largest component of the sciatic nerve is derived from the ventral branches of ventral rami of L4, L5, S1, S2, and S3. It originates from the sciatic nerve and runs through the back of thigh, popliteal fossa and back of leg to end at the junction between the medial malleolus and the medial tubercle of calcaneus. The study was done to find the level of origin termination, and the motor branching pattern of the tibial nerve to the deep muscles of the posterior Leg.
Material and Methods: This Study was Carried out, total 60 adult lower limbs were dissected from the back of the thigh to the ankle. The level of origin of tibial nerve from sciatic nerve above the apex of head of fibula was measured in cms. The range, mean and standard deviation were calculated. The muscular branching pattern and the number of muscular branches to each muscle were noted. The level of termination of Tibial nerve in relation to malleolar calcaneal axis was observed. Percentage for all the variables was calculated.
Conclusion: The anatomy of the tibial nerve in the posterior Leg was found to be complex and variable. Such high variability in the origin, termination, and motor branching pattern puts the nerve under high risk for iatrogenic injuries while performing procedures like popliteal block anaesthesia, motor nerve block, neurotomies, free fibular graft and decompression techniques in compartment syndrome.
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