Tibial nerve branching pattern and compatibility of branches for the deep fibular nerve

• Published in: Surgical and radiologic anatomy (English ed.) 2024-04, Vol.46 (4), p.413-424
• Main Authors: Yilmaz, Mehmet, Gungor, Yigit, Salman, Necati, Comert, Ayhan, Esmer, Tulin Sen, Esmer, Ali Firat
• Format: Article
• Language: English
• Subjects: Anatomy; Cadavers; Connective tissue; Feet; Imaging; Injuries; Medicine; Medicine & Public Health; Original Article; Orthopedics; Radiology; Soleus muscle; Surgery; Tibial nerve
• ISSN: 1279-8517; 0930-1038; 1279-8517
• DOI: 10.1007/s00276-024-03329-6

Purpose In individuals who develop drop foot due to nerve loss, several methods such as foot-leg orthosis, tendon transfer, and nerve grafting are used. Nerve transfer, on the other hand, has been explored in recent years. The purpose of this study was to look at the tibial nerve’s branching pattern and the features of its branches in order to determine the suitability of the tibial nerve motor branches, particularly the plantaris muscle motor nerve, for deep fibular nerve transfer. Methods There were 36 fixed cadavers used. Tibial nerve motor branches were observed and measured, as were the lengths, distributions, and thicknesses of the common fibular nerve and its branches at the bifurcation region. Result The motor branches of the tibial nerve that supply the soleus muscle, lateral head, and medial head of the gastrocnemius were studied, and three distinct forms of distribution were discovered. The motor branch of the gastrocnemius medial head was commonly observed as the first branch to divide, and it appeared as a single root. The nerve of the plantaris muscle was shown to be split from many origins. When the thickness and length of the motor branches measured were compared, the nerve of the soleus muscle was determined to be the most physically suited for neurotization. Conclusion In today drop foot is very common. Traditional methods of treatment are insufficient. Nerve transfer is viewed as an application that can both improve patient outcomes and hasten the patient’s return to society. The nerve of the soleus muscle was shown to be the best candidate for transfer in our investigation.