胫神经与跗管关系的解剖学研究：一项尸体研究。

Anatomy of the tibial nerve in relation to the tarsal tunnel: A cadaveric study.

作者信息

Mattos Ivan, Ubillus Hugo A, Campos Gustavo, Soares Sergio, Azam Mohammad T, Oliva Xavier Martin, Kennedy John G

机构信息

SAANA El Golf Clinic, Orthopedic Surgery, Lima, Peru.

NYU Langone Health, Department of Orthopedic Surgery, New York, NY, United States.

出版信息

Foot Ankle Surg. 2022 Dec;28(8):1415-1420. doi: 10.1016/j.fas.2022.07.011. Epub 2022 Aug 4.

DOI:10.1016/j.fas.2022.07.011

PMID:35985969

Abstract

BACKGROUND

Tarsal tunnel syndrome (TTS) is typically caused by an anatomical variant or mechanical compression of the tibial nerve (TN) with variable success after surgical treatment.

METHOD

40 lower-leg specimens were obtained. Dissections were appropriately conducted. Extremities were prepared under formaldehyde solution. The tibial nerve and branches were dissected for measurements and various characteristics.

RESULTS

The flexor retinaculum had a denser consistency in 22.5% of the cases and the average length was 51.9 mm. The flexor retinaculum as an independent structure was absent and 77.2% of cases as an undistinguished extension of the crural fascia. The lateral plantar nerve (LPN) and abductor digiti minimi (ADM) nerve shared same origin in 80% of cases, 34.5% bifurcated proximal to the DM (Dellon-McKinnon malleolar-calcaneal line) line 31.2% distally and 34.3% at the same level.

CONCLUSION

Understanding the tibial nerve anatomy will allow us to adapt our surgical technique to improve the treatment of this recurrent pathology.

摘要

背景

跗管综合征（TTS）通常由胫神经（TN）的解剖变异或机械性压迫引起，手术治疗后效果不一。

方法

获取40个小腿标本。进行适当的解剖。在甲醛溶液中制备肢体。解剖胫神经及其分支以进行测量和观察各种特征。

结果

22.5%的病例中屈肌支持带质地较致密，平均长度为51.9毫米。77.2%的病例中屈肌支持带并非独立结构，而是小腿筋膜难以区分的延续部分。80%的病例中足底外侧神经（LPN）和小趾展肌（ADM）神经有共同起源，34.5%在Dellon-McKinnon踝-跟线（DM线）近端分叉，31.2%在远端分叉，34.3%在同一水平分叉。