The bifurcation and topography of the posterior tibial artery within the tarsal tunnel

Purpose The tarsal tunnel (TT) is a fibro-osseous anatomical space coursing from the medial ankle to the medial midfoot. This tunnel acts as a passage for both tendinous and neurovascular structures, including the neurovascular bundle containing the posterior tibial artery (PTA), posterior tibial ve...

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Bibliographic Details
Published in:Surgical and radiologic anatomy (English ed.) 2023-05, Vol.45 (5), p.611-622
Main Authors: Marchese, B., McDonald, A., McGowan, H.
Format: Article
Language:English
Subjects:
Anatomy
Ankle
Cadavers
Compression
Humans
Iatrogenesis
Iatrogenic Disease - prevention & control
Imaging
Irritation
Medicine
Medicine & Public Health
Neuropathy
Original
Original Article
Orthopedics
Radiology
Surgery
Tarsal Tunnel Syndrome - etiology
Tarsal Tunnel Syndrome - surgery
Tibial Arteries
Tibial Nerve
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Summary:Purpose The tarsal tunnel (TT) is a fibro-osseous anatomical space coursing from the medial ankle to the medial midfoot. This tunnel acts as a passage for both tendinous and neurovascular structures, including the neurovascular bundle containing the posterior tibial artery (PTA), posterior tibial veins (PTVs) and tibial nerve (TN). Tarsal tunnel syndrome (TTS) is the entrapment neuropathy that describes the compression and irritation of the TN within this space. Iatrogenic injury to the PTA plays a significant role in both the onset and exacerbation of TTS symptoms. The current study aims to produce a method to allow clinicians and surgeons to easily and accurately predict the bifurcation of the PTA, to avoid iatrogenic injury during treatment of TTS. Methods Fifteen embalmed cadaveric lower limbs were dissected at the medial ankle region to expose the TT. Various measurements regarding the location of the PTA within the TT were recorded and multiple linear regression analysis performed using RStudio. Results Analysis provided a clear correlation ( p  
ISSN:1279-8517
0930-1038
1279-8517
DOI:10.1007/s00276-023-03115-w